Referral of a patient to Ontario Health atHome for home and community care services.
- Completed by
- Referring physician, NP or other provider
- Issued by
- Ontario Health atHome
- Format
- Language
- English
Ontario ADP Ostomy Grant Application (1945-67E)
Ontario's Assistive Devices Program uses this short application to pay an annual grant toward ostomy supplies for people living in the community, a long-term residence or a long-term care home. The physician or nurse practitioner confirms the type of ostomy and the surgery date. The grant goes directly to the applicant, agent or long-term care home in two instalments a year.
Who completes it
A physician or nurse practitioner completes Section 2, ticking the ostomy type and surgery date, and signs Section 4 certifying the surgical intervention. The applicant or agent completes Section 1, signs Section 3 and names the payee.
Submitting and payment
- How to submit it
- Send the signed form to ADP; attachments aren't considered. ADP takes about six weeks to review a properly completed form, and the first grant payment follows about two weeks after approval.
Good to know
- Section 2 lists permanent colostomy, ileostomy, fecal continent reservoir, urostomy, ileal conduit and urinary continent reservoir. ADP's information sheet says temporary ostomies needed under six months aren't funded.
- ADP funds at most two ostomies, and because a colostomy and an ileostomy are incompatible, it funds only one of those two.
- The grant is higher for people on Ontario Works, ODSP or ACSD and for long-term care residents. Applicants keep original supply receipts for two years.
- ADP mails a renewal form every two years to confirm eligibility, and the physician doesn't need to sign the renewal.
Get the official form
Download the current version from the source each time; forms change without notice.
Application for Funding Ostomy Grant
Demande de subvention pour stomisés
Fill it with Vero
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
How this list is checked
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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Frequently asked questions
Does the surgeon have to sign the ADP ostomy grant form?
No. ADP says the family physician or nurse practitioner may sign the application after examining the applicant and confirming they need ostomy supplies. The signer certifies the applicant had surgery resulting in the ostomy indicated in Section 2 and adds their six-digit OHIP billing number.
How does the ADP ostomy grant work?
ADP pays a set annual amount per ostomy directly to the payee in two instalments, every six months. The grant is a contribution toward costs, not full coverage, and supplies can be bought from any supplier. Applicants must update ADP themselves about changes in name, address or banking information.
How often does the ostomy grant need to be renewed?
Every two years. ADP mails a renewal form to the applicant or agent, who completes it and mails or faxes it back for payments to continue. A physician's signature isn't required on the renewal. If a cheque is returned undeliverable, ADP temporarily cancels the grant until records are corrected.