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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
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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
- Follow up and Review
- Repairs and Maintenance
- Collections and Returns
- Training
- Equipment Procedures
- Home Modification Procedures
- Recently Updated Documents
Frequently Used Documents
Documents
- Delegate Approval Request Form (DOCX 172.7 KB)
- Care and Use of a Powered Mobility Aid (DOC 139.5 KB)
- Equipment Request Form DHS Equipment Program (DOCX 149.3 KB)
- Equipment In Scope List (XLSX 139.8 KB)
- Equipment Selection Agreement Form (DOCX 92.6 KB)
- Equipment Program Services and Access Overview (DOC 3.7 MB)
- Home Modifications In Scope List (XLSX 81.5 KB)
- Home Modification Prescription Agreement Form DHS Equipment Program (DOCX 97.2 KB)
- Key Approval Criteria for Equipment
- Key Approval Criteria for Home Modifications
- Priority scoring communication and assistive technology (DOCX 170.8 KB)
- Risk rating and priority scoring form (DOCX 126.3 KB)
- Terms and Conditions and Information on Use of Equipment (DOCX 86.9 KB)
- Terms and Conditions of Installation of Home Modifications (DOCX 104.3 KB)
Last updated:01 Nov 2023 9:03pm
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