Application

Application Forms

To apply for funding of Durable Medical Equipment please fill out the Application. Applications that are incomplete will not be returned and a new application will need to be completed for consideration.
The Application Includes:
• ADF Grant Application 2015
•ADF Grant Terms and Conditions 2015
•ADF Grant Information 2015
•ADF HIPAA Form 2015

All applications will be reviewed in a timely fashion. Applications will be reviewed without regard to race, color, religion, sex, or national origin. Applicants with completed applications will be notified by mail.