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Equipment Program
Document lists
- Frequently Used Documents
- Document Search
- Program Area
- Assistive Technology Specification Forms
- Selecting Equipment
- Selecting Home Modifications
- Home Modification Templates
-
DHS Equipment Program Documents
- Equipment Program Eligibility Documents
- Prescribing Equipment - by Document Type
- Prescribing Equipment - by Equipment Type
- Prescribing a Home Modification - by Type
- Approvals
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- Home Modification Procedures
- Recently Updated Documents
Selecting Home Modifications
The following list of documents support home modification selection such as understanding clinical considerations, completing an assessment, taking measurements and determining features.
Clinical Considerations for Prescribers
Bathroom
Bathroom Clinical Considerations for Prescribers (MS Word Document 162.5 KB)- Bathroom Electrical Safety Clinical Considerations for Prescribers (MS Word Document 300.0 KB)
- Shower Hoses Clinical Considerations for Prescribers (MS Word Document 135.0 KB)
Kitchen
- Kitchen Clinical Considerations for Prescribers (MS Word Document 148.5 KB)
Rails
- Grab Rails Clinical Considerations for Prescribers (MS Word Document 148.5 KB)
Ramps
- Ramps Clinical Considerations for Prescribers (MS Word Document 156.0 KB)
Step Modifications
- Steps Clinical Considerations for Prescribers (MS Word Document 146.5 KB)
Fact Sheets
Bathroom
- Applying a Plastic Sheet Over Electrical Outlets Fact Sheet (MS Word Document 154.0 KB)
Forms - Assessment
Unspecified
- DHS EP ACC Client Registration Form (MS Word Document 98.2 KB)
- Advanced Palliative Equipment Response Assessment Request Form (MS Word Document 124.4 KB)
Bathroom
- Major Bathroom Modification Assessment Form (MS Word Document 157.5 KB)
Kitchen
- Major Kitchen Modification Assessment Form (MS Word Document 126.5 KB)
Forms - Specifications
Access
- Home Modification Specification Form Internal Access Doorway Widening (MS Word Document 121.0 KB)
- Minor Access Home Modification Specification Form (MS Word Document 163.0 KB)
- Minor Home Modification Blank Specification Form (MS Word Document 90.0 KB)
Bathroom
- Home Modification Specification Form Bathroom / Toilet (MS Word Document 144.0 KB)
- Shower Platform Specification Form (MS Word Document 94.0 KB)
Kitchen
- Home Modification Specification Form Kitchen (MS Word Document 124.5 KB)
Ramps
- Home Modification Specification Form Long Ramp (MS Word Document 149.5 KB)
Step Modifications
- Home Modification Specification Form Major Step (MS Word Document 118.0 KB)
Reference Documents - Prescription
Unspecified
Home Modifications In Scope List (MS Excel Document 81.5 KB)
Access
- Access and Mobility Reference Charts AS1428.1 (MS Word Document 77.4 KB)
- Circulation Spaces at Doorways Appendix C AS1428 1 2001 (MS Word Document 417.7 KB)
- Circulation Spaces at Doorways Fig 1 AS1428 1 2009 (MS Word Document 371.2 KB)
Bathroom
- Bathroom Electrical Safety Training Resource Kit (MS Word Document 1.5 MB)
Last updated:01 Nov 2023 9:03pm
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