How to Fill the SASSA Medical Referral Form
Last updated: 14 April 2026
The SASSA Medical/Assessment Referral form is used to refer a grant applicant to a medical practitioner for a disability or care dependency assessment. It is completed by the treating practitioner and submitted as part of the Disability Grant (DG) or Care Dependency Grant (CDG) application. The form records the client's medical history, diagnosis, treatment compliance, and recommends the type of assessment needed.
What documents do I need?
Gather these before you start. Missing or incomplete documents are one of the most common reasons applications are delayed or rejected.
- South African ID document (valid green ID book, Smart ID card, or temporary ID certificate for the client)
- SASSA grant application reference number (issued when the initial DG or CDG application was submitted)
- Existing medical records or specialist reports relevant to the disability or condition
- List of current medications and dosages prescribed to the client
- Hospital discharge summaries, if the client has been hospitalised for the condition
- X-ray, MRI, or scan results relevant to the diagnosis, if available
Step 1: Obtain the referral form from SASSA
When you apply for a Disability Grant or Care Dependency Grant at your nearest SASSA office, SASSA will issue the Medical/Assessment Referral form. Take this form to your treating doctor or health practitioner. Do not attempt to fill in the medical sections yourself — the form must be completed by a registered health professional.
Step 2: Fill in the client's personal details
Enter the client's South African ID number, gender, form of identification, surname, and full names. These details must match the client's ID document exactly. The SASSA office may pre-fill some of these fields before issuing the form.
Step 3: Complete the medical history section
The treating practitioner fills in the presenting problem or symptoms, clinical diagnosis, any complications, whether the client is compliant with treatment, and whether the client abuses illegal substances. The practitioner also records how the condition has changed over the past 6 months (improved, stabilized, or worsened) and provides remarks on functional capacity.
Step 4: Recommend the assessment type
The practitioner selects the type of health professional recommended to conduct the disability assessment: MP (Medical Practitioner), PT (Physiotherapist), OT (Occupational Therapist), AUD (Audiologist), or Other. Choose the specialist most appropriate for the client's condition.
Step 5: Sign the practitioner declaration
The treating practitioner enters their full names, date, telephone and cellphone numbers, and professional registration number (HPCSA or SANC). The practitioner must sign the form to certify the information provided is accurate.
Step 6: Return the form to SASSA
Take the completed and signed referral form back to the SASSA office where the grant application was submitted. SASSA will use the form to schedule a medical assessment appointment. The medical assessment is free of charge — SASSA arranges and pays for it. Do not pay anyone who claims to conduct a SASSA assessment privately. Keep a copy of the completed form for your records.
What are common mistakes to avoid?
- Not having the form completed by a registered health professional — the medical sections must be filled in by a doctor, physiotherapist, occupational therapist, or other HPCSA/SANC-registered practitioner
- Entering an incorrect ID number — the 13-digit SA ID number must match the client's identity document exactly
- Leaving the diagnosis or presenting problem blank — these fields are required for SASSA to schedule the correct type of assessment
- Forgetting to include the practitioner's registration number — the HPCSA or SANC number validates the practitioner's credentials
- Not signing the practitioner declaration — an unsigned form will be returned by SASSA and delay the assessment
- Submitting the form without returning it to SASSA — the form must be handed back to the SASSA office to trigger the assessment scheduling
What tips will help my application succeed?
- Ask your treating doctor to be as detailed as possible in the diagnosis and functionality remarks — this helps the assessor understand your condition
- Bring all your medical records, specialist letters, and medication lists to the practitioner appointment to ensure the form is completed accurately
- If you see multiple specialists, ask the one most familiar with your primary disability to complete the form
- Keep a photocopy of the completed form before returning it to SASSA — you may need it if you appeal the assessment outcome
- If your condition worsens before the assessment date, ask your practitioner to provide an updated medical letter to present at the assessment
- Call the SASSA toll-free number 0800 60 10 11 to check on the status of your medical assessment appointment