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Leads Form for Mobility Equipment through ADP

Fill this form if the client is looking for Mobility equipment through Assistive Device Program.

Fill any email if they don't have one.
What product are they looking to get? Not everything is covered through funding programs.
Choose the category of the product. 
Make sure they have valid health card. Make sure its not expired. If it is, ask the client to get it renewed before processing the claim.
Canadian Citizen and Permanent Resident may apply for a product through ADP. Refugee can apply though IFHP. Work Permit holder are not eligible.
Check whether the client received any funding for any mobility equipment in past five years. We can only apply after five years unless there is a condition change.
Fill any medical condition and disability atleast six months or older. The disability has to be older than Six Months. If its less than 6 Months, they might not be eligible.
Every Assistive Device Program(ADP) case requires an ADP Authorized Authorizer. The case cannot be submitted without their authorization. Not every Physiotherapist or Occupational Therapist is ADP Authorized.
Private Occupational Therapist charge a fee for Private Assessment. Fee for a walker can be from $80 to $100, Wheelchair from $150 to $250, Powerchair or Mobility Scooter from $300 to $400.
If the injury is from Motor or Vehicle accident, The insurance company will pay for all the Equipment.
If the client is getting benefits from WSIB, ADP will not pay for any Mobility Equipment
ADP pays full 100% for these clients.