Used by clients to request funding assistance for Insulin Pumps and Supplies for Children

Used to renew funding for home oxygen therapy.

Application for Funding Mobility Devices

This form is used by Manufacturer's Testing Facilities to report testing of Manual Wheelchairs.

This form is used by Manufacturer's Testing Facilities to report testing of Ambulation Aids

Used to apply for Funding for Communication Aids

For Specialist physician & ADP registered authorizers to request funding for extraoral (facial) prostheses.

For Specialist physician & ADP registered authorizer to request funding for intraoral (mouth) prostheses.

Used by clients to apply for funding for a silicone breast prosthesis(es)

Used to apply for Funding for Ventilator Equipment and Supplies

Used by Canadian board -certified orthotists registered with ADP to request funding for custom -made orthoses

Used to apply for Funding for Pressure Modification Devices

Used to apply for Funding for Respiratory Equipment & Supplies

Used by Amputee Team, registered with ADP to request funding for conventional upper/lower limb prosthees.

Used by senior clients, 65 years and older, who are on daily insulin injections to apply for funding for syringes.

To be used for all applications for Home Oxygen Therapy funding.

This form is used by Manufacturers to report testing of Powered Mobility Devices

Application used to determine elegibility for funding by ADP for insulin pumps and supplies

The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of assistive devices who is requesting registration with the Assistive Devices Program.

Written consent to release information enables the Assistive Devices Program to provide a history of previously funded equipment/supplies to a client and/or third party as specified.