Funding forms and documents
Current application forms, supporting forms and program guides for Ontario equipment funding, for clients, families, authorizers and therapists. Free to download, no sign-up.
Choose Download PDF to save the issuer's own form, checked against its official source. Choose an official link to open the program's form or online application on its own website.
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Showing all 37 documents
No documents match that search. Try a program name such as ADP, or clear the filters.
Assistive Devices Program (ADP)
About this programOntario funding for mobility devices such as walkers, wheelchairs, scooters and seating. An ADP authorizer assesses the client and a registered vendor completes the vendor section of the application.
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Download PDF: Application for Funding Mobility Devices (English)
Application for Funding Mobility Devices (English)
Version 2196-67E (2023/01). PDF, 2.0 MB. Fillable form: open it in Adobe Acrobat Reader, not a web browser.
One form covers walkers, wheelchairs, power bases, scooters and seating.
Checked 2026-09-15 against the official forms.mgcs.gov.on.ca page.
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Download PDF: Application for Funding Mobility Devices (French)
Application for Funding Mobility Devices (French)
Version 2196-67F (2023/01). PDF, 2.1 MB. Fillable form: open it in Adobe Acrobat Reader, not a web browser.
Checked 2026-09-15 against the official forms.mgcs.gov.on.ca page.
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Download PDF: Applicant Information Sheet: wheelchairs, seating and walking aids
Applicant Information Sheet: wheelchairs, seating and walking aids
Version 2196-67E (2026/05). PDF, 159 KB, 2 pages.
Checked 2026-09-15 against the official forms.mgcs.gov.on.ca page.
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Download PDF: Mobility Devices Product Manual
Mobility Devices Product Manual
Version Effective January 1, 2026. PDF, 1.2 MB, 128 pages.
Checked 2026-09-15 against the official ontario.ca page.
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Download PDF: Mobility Devices Policy and Administration Manual
Mobility Devices Policy and Administration Manual
Version July 2023. PDF, 266 KB, 54 pages.
Checked 2026-09-15 against the official ontario.ca page.
Ontario Disability Support Program (ODSP)
About this programAsk your ODSP caseworker about help with equipment. You can apply for ODSP online, and people who already receive ODSP can use the forms below.
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Start the official online application: Apply for ODSP income support
Apply for ODSP income support
Online on sada.mcss.gov.on.ca.
Checked 2026-09-15 against the official ontario.ca page.
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Download PDF: Mandatory Special Necessities Benefit Application
Mandatory Special Necessities Benefit Application
Version ON00646E (2025/11). PDF, 1.4 MB, 4 pages, fillable.
Only for people who already receive ODSP. French and large print versions are on the official page.
Checked 2026-09-15 against the official forms.mgcs.gov.on.ca page.
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Download PDF: Peel ODSP Discretionary Benefit Request
Peel ODSP Discretionary Benefit Request
Version V-10-700 (2025/10). PDF, 456 KB, 1 page, fillable.
Checked 2026-09-15 against the official peelregion.ca page.
March of Dimes Home and Vehicle Modification Program (HVMP)
About this programOpen the current forms directly from March of Dimes. Large-print versions are also available.
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Open the official PDF: HVMP Program Application (English)
HVMP Program Application (English)
Online on marchofdimes.ca.
Checked 2026-09-15 against the official marchofdimes.ca page.
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Open the official PDF: HVMP Program Application (French)
HVMP Program Application (French)
Online on marchofdimes.ca.
Checked 2026-09-15 against the official marchofdimes.ca page.
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Open the official PDF: Verification of Disability (English)
Verification of Disability (English)
Online on marchofdimes.ca.
Checked 2026-09-15 against the official marchofdimes.ca page.
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Open the official PDF: Verification of Disability (French)
Verification of Disability (French)
Online on marchofdimes.ca.
Checked 2026-09-15 against the official marchofdimes.ca page.
WSIB
About this programWSIB authorizes equipment and supplies through an allowed claim, with a prescription. Health care providers bill WSIB for approved items with form 3941A.
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Download PDF: Provider Payment Request for Equipment/Supplies (3941A)
Provider Payment Request for Equipment/Supplies (3941A)
Version 3941A (04/15). PDF, 315 KB, 3 pages, fillable.
For billing equipment WSIB has already approved. It is not an application for equipment coverage.
Checked 2026-09-15 against the official wsib.ca page.
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Read the official policy: Health Care Equipment and Supplies policy
Health Care Equipment and Supplies policy
Version 17-07-06. Online on wsib.ca.
Checked 2026-09-15 against the official wsib.ca page.
Veterans Affairs Canada (VAC)
About this programEquipment and home adaptations need VAC pre-authorization and a prescription. Veterans can make requests through My VAC Account.
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Go to the official sign-in page: My VAC Account
My VAC Account
Online on veterans.gc.ca.
Checked 2026-09-15 against the official veterans.gc.ca page.
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Read the official policy: Equipment, Home Adaptations and Vehicle Modifications policy (POC 13)
Equipment, Home Adaptations and Vehicle Modifications policy (POC 13)
Online on veterans.gc.ca.
Checked 2026-09-15 against the official veterans.gc.ca page.
Interim Federal Health Program (IFHP)
About this programIRCC asks for an IFHP coverage application in specific cases, such as missing eligibility documents or restarting coverage. Read Guide 5568, fill out IMM 5564, then upload it in your IRCC secure account.
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Download PDF: Application for Interim Federal Health Program Coverage (IMM 5564)
Application for Interim Federal Health Program Coverage (IMM 5564)
Version IMM 5564 (06-2019) E. PDF, 965 KB, 2 pages, fillable.
Save the form to your computer and open it in Adobe Acrobat Reader to fill it out, then upload it in your IRCC secure account.
Checked 2026-09-15 against the official canada.ca page.
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Read the official guide: Guide 5568: how to apply for IFHP coverage
Guide 5568: how to apply for IFHP coverage
Online on canada.ca.
Checked 2026-09-15 against the official canada.ca page.
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Search the official provider list: Find a registered IFHP provider
Find a registered IFHP provider
Online on ifhp.medaviebc.ca.
Checked 2026-09-15 against the official ifhp.medaviebc.ca page.
Blue Cross
About this programCoverage depends on your own plan. Ontario Blue Cross members can claim with the extended health care form, and Medavie Blue Cross members claim online.
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Download PDF: Ontario Blue Cross Extended Health Care Claim Form
Ontario Blue Cross Extended Health Care Claim Form
Version 01ONT0355A (2021-12). PDF, 70 KB, 2 pages, fillable.
Check your plan booklet first: some equipment needs approval before you buy.
Checked 2026-09-15 against the official on.bluecross.ca page.
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Claim on the official member page: Medavie Blue Cross member claims
Medavie Blue Cross member claims
Online on medaviebc.ca.
Checked 2026-09-15 against the official medaviebc.ca page.
City of Toronto Hardship Fund
About this programApply by phone at 416-338-8888, option 3. If you receive Ontario Works or ODSP, ask your caseworker.
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Read the official page: Hardship Fund: how to apply
Hardship Fund: how to apply
Online on toronto.ca.
Checked 2026-09-15 against the official toronto.ca page.
Easter Seals Ontario
For children and youth in Ontario. A child must be registered with Easter Seals Ontario before an equipment funding request.
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Download PDF: Easter Seals Ontario Registration Application
Easter Seals Ontario Registration Application
Version April 2025. PDF, 438 KB, 5 pages, fillable.
Checked 2026-09-15 against the official services.easterseals.org page.
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Download PDF: Equipment Funding Request (EFR) and program guidelines
Equipment Funding Request (EFR) and program guidelines
Version May 2025. PDF, 320 KB, 5 pages, fillable.
Checked 2026-09-15 against the official services.easterseals.org page.
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Download PDF: Approved Equipment List 2026
Approved Equipment List 2026
Version Rev. 04-30-2026. PDF, 189 KB, 1 page.
Checked 2026-09-15 against the official services.easterseals.org page.
MS Canada Quality of Life Program
For people living with MS. MS Canada takes applications online; the printable versions are for anyone who cannot use the online form.
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Apply on the official online form: Quality of Life Application
Quality of Life Application
Online on mssp.tfaforms.net.
Checked 2026-09-15 against the official mscanada.ca page.
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Open the official online form: Healthcare Professional Assessment Form
Healthcare Professional Assessment Form
Online on mssp.tfaforms.net.
Checked 2026-09-15 against the official mscanada.ca page.
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Download PDF: Quality of Life Program Equipment Guidelines
Quality of Life Program Equipment Guidelines
PDF, 1.3 MB, 5 pages.
Checked 2026-09-15 against the official mscanada.ca page.
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Download PDF: Equipment Grant Application (printable)
Equipment Grant Application (printable)
PDF, 787 KB, 6 pages, fillable.
Checked 2026-09-15 against the official mscanada.ca page.
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Download PDF: Equipment Repair Application (printable)
Equipment Repair Application (printable)
PDF, 618 KB, 3 pages, fillable.
Checked 2026-09-15 against the official mscanada.ca page.
Muscular Dystrophy Canada Equipment Program
Register as a client first, then apply online for equipment.
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Download PDF: Client Registration Form
Client Registration Form
Version Updated 2025/08/26. PDF, 249 KB, 4 pages, fillable.
Checked 2026-09-15 against the official muscle.ca page.
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Apply on the official online form: Equipment Program Entry Form
Equipment Program Entry Form
Online on form.jotform.com.
Checked 2026-09-15 against the official muscle.ca page.
Holland Bloorview Family Support Fund
Applications are online. Check the official page for the current funding window before you apply.
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Download PDF: Family Support Fund: items eligible (2026-2027)
Family Support Fund: items eligible (2026-2027)
Version 2026-2027. PDF, 128 KB, 2 pages.
Checked 2026-09-15 against the official hollandbloorview.ca page.
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Apply on the official online form: Family Support Fund application
Family Support Fund application
Online on redcap.hollandbloorview.ca.
Checked 2026-09-15 against the official hollandbloorview.ca page.
Jennifer Ashleigh Children's Charity
Applications are online. Read the qualifying criteria first.
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Download PDF: Qualifying Criteria
Qualifying Criteria
Version April 2025. PDF, 295 KB, 2 pages.
Checked 2026-09-15 against the official jenash.org page.
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Open the official application portal: Online application portal
Online application portal
Online on goapply2.akoyago.com.
Checked 2026-09-15 against the official jenash.org page.
Tax credits
The federal Home Accessibility Tax Credit is claimed on line 31285 of your annual tax return.
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Read the official CRA page: Home Accessibility Tax Credit (line 31285)
Home Accessibility Tax Credit (line 31285)
Online on canada.ca.
Checked 2026-09-15 against the official canada.ca page.
Looking for an older form? What we replaced and why
- ADP Application (Printable). A flattened copy made outside the ministry from the 2023/01 ADP form (all 13 pages as images), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application for Rollators. A flattened copy made outside the ministry from the 2023/01 ADP form (trimmed to rollator pages), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application for Wheelchairs. A flattened copy made outside the ministry from the 2023/01 ADP form (trimmed to manual wheelchair pages), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application for Mobility Scooters. A flattened copy made outside the ministry from the 2023/01 ADP form (trimmed to scooter pages), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application for Power Wheelchairs. A flattened copy made outside the ministry from the 2023/01 ADP form (trimmed to power wheelchair pages), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application for Seating. A flattened copy made outside the ministry from the 2023/01 ADP form (trimmed to seating pages), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application Page 11. A flattened copy made outside the ministry from the 2023/01 ADP form (page 11, Section 3 applicant consent), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application Page 12. A flattened copy made outside the ministry from the 2023/01 ADP form (page 12, Section 4 authorizer and vendor signatures), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- ADP Application Page 11 and 12. A flattened copy made outside the ministry from the 2023/01 ADP form (pages 11 and 12, Sections 3 and 4), so it cannot be filled in. The current official form covers every mobility device and includes all sections.
- March of Dimes HVMP Funding Application: Home Adaptations and Devices. A September 2024 form (HV 00-00bm 09/24). March of Dimes now links one 2025 Program Application in its place.
- March of Dimes HVMP Funding Application: Home Modification (Construction). A September 2024 form (HV 00-00bk 09/24). March of Dimes now links one 2025 Program Application in its place.
- March of Dimes Verification of Disability. A September 2024 version (HV 01-03b 09/24). The 2025 Verification of Disability is the one March of Dimes links now.
- ODSP Funding Application Guidelines. This file is form 3188, What to Expect in ODSP Employment Supports: an employment handout, not funding guidelines. It is no longer on Ontario's forms site, and ODSP offices hand out the current version.
- ODSP Application for Employment Support. An ODSP Employment Supports application about help finding work, not equipment. It is no longer on Ontario's forms site; ODSP offices and employment service providers give out the current package.
- ODSP Verification of Disability / Impairment. The 2010 Employment Supports verification form (2884). It is no longer on Ontario's forms site and is part of the package ODSP gives applicants.
- Hardship Funding Application. This is OPSEU's Regional Hardship Fund form (Form 108) for union members, not the City of Toronto Hardship Fund. The Toronto fund's application route is in its entry above.
- Easter Seal Registration Application. The August 2021 form. Easter Seals Ontario now links the April 2025 registration application.
- Easter Seals Funding Application. The August 2021 form. Easter Seals Ontario now links the May 2025 Equipment Funding Request.
- Easter Seals Funding and Criteria. A 2020 list. Easter Seals Ontario now links the Approved Equipment List 2026.
- Multiple Sclerosis Society Guidelines. A 2014 MS Society memo. MS Canada now publishes current Quality of Life guidelines and an online application.
- Multiple Sclerosis Society Funding Application. This 2015 link now returns a page not found error. MS Canada's current application is online, with a printable version.
- Muscular Dystrophy Canada Funding Application. A 2020 Equipment Program form that Muscular Dystrophy Canada no longer links. Registered clients now apply online.
Need help with a form?
Each program decides eligibility and funding itself. If you are not sure which form applies to you, call us during business hours or read the funding guide.