This Assistive Technology and Home Modifications (ATHM) Prescription Template is designed to support Occupational Therapists in documenting clinical assessment, trials, and recommendations when prescribing assistive technology or home modifications under the Support at Home Assistive Technology and Home Modifications (ATHM) Scheme.
The template has been adapted from the example documentation structure provided by the Department of Health and Aged Care, with additional sections to support clearer clinical reasoning, risk consideration, and documentation of trials and outcomes in real-world practice.
 
The template:
Guides structured documentation of functional assessment and environmental considerations
Prompts documentation of equipment or modification trials and outcomes
Supports clear clinical justification aligned with functional goals
Documents risk considerations and mitigation strategies
Assists in linking recommendations to safety, independence, participation, and care sustainability
 
This structure is intended to support transparent, defensible clinical reasoning when prescribing assistive technology or home modifications in community aged care.
This form may be:
Used as a combined assessment and prescription report for submission to aged care providers or funding decision-makers
Used as an internal prescription template, with sections extracted into organisational reporting formats where required
Shared with the participant, care partner, or provider to support understanding of the rationale for recommendations