The Assistive Devices Program (ADP) is a government-funded program that provides financial assistance to individuals with physical disabilities to purchase assistive devices․ The program aims to increase mobility and functional independence for adults with physical disabilities who are in financial need․ In this article, we will provide an overview of the Assistive Devices Program application form PDF and guide you through the process of applying for funding․
Eligibility Criteria
To be eligible for the Assistive Devices Program, applicants must meet the following criteria:
- Be 19 years of age or older
- Have an ongoing physical limitation that requires the use of an assistive device
- Be in financial need
Applicants must also be residents of Ontario and have a valid health card․
Application Form PDF
The Assistive Devices Program application form PDF can be downloaded from the official website of the March of Dimes․ The form is available in French and English and can be completed electronically or manually․ The form requires applicants to provide personal and medical information, including:
- Client name and address
- Phone number and email
- Doctor’s name and contact information
- Medical diagnosis and description of physical limitation
Applicants must also sign the application form, or if unable to sign, have someone with legal authority to act on their behalf sign the form․
Required Documents
In addition to the application form, applicants must provide supporting documents, including:
- A doctor’s confirmation form, signed and dated by the applicant’s doctor
- Proof of income and financial need
- Proof of residency in Ontario
Applicants must also provide a detailed description of the assistive device required, including the type, model, and cost of the device․
Submission and Review Process
Completed application forms and supporting documents must be submitted to the Assistive Devices Program office․ The application will be reviewed to determine eligibility and funding eligibility․ Applicants will be notified in writing of the decision, and if approved, will receive funding for the approved assistive device․
Contact Information
For more information about the Assistive Devices Program application form PDF, applicants can contact the program office at:
- Address: 5700 Yonge Street, 7th floor, Toronto, ON M2M 4K5
- Phone: 416-327-8804
- Toll-free: 1-800-268-6021
- TTY: 416-327-4282
Applicants can also visit the official website of the March of Dimes for more information and to download the application form PDF․
The Assistive Devices Program application form PDF is a vital resource for individuals with physical disabilities who require financial assistance to purchase assistive devices․ By following the guidelines outlined in this article, applicants can ensure a smooth and successful application process․ Remember to review the eligibility criteria, complete the application form accurately, and provide all required supporting documents to increase your chances of approval․