Fill and send out this form if you wish to apply for assistance due to indigence.

Fill and send out this form if you wish to apply for assistance due to disability.

This form is for providing consent for a meeting/interview with the Association.

Fill out and send this form to apply for membership to the Association.

This form is to be used when applying for assistance.

This form is to be used when equipment is on loan from the Association.

Witness affidavit to verify a Releasor's ability to make a valid Release.

Form to be filled out by a doctor to verify and certify applicant disability status

Form to be filled out by a doctor to re-verify and re-certify applicant disability status

This form is to be used when applying for assistance by both the applicant and provider.

This service is not currently offered, but we plan to implement this in the near future.

This form is to be used when designating a beneficiary.