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Ontario ADP Hearing Devices Application (3224-67E)

Ontario's Assistive Devices Program uses this application to fund hearing aids, FM systems, replacement cochlear implant and bone-anchored hearing aid processors, TTYs and signalling devices for people with long-term hearing loss. An ADP-registered authorizer assesses hearing and selects the device, a physician or audiologist signs as prescriber, and the registered vendor submits the form to ADP electronically.

Who completes it

The authorizer, an ADP-registered audiologist or, for adults, a hearing instrument specialist, completes Section 2 and signs, while a physician or audiologist signs the prescriber certification in Section 4. The applicant or agent signs Section 3 and the proof of delivery, and the vendor completes the equipment specifications.

Submitting and payment

How to submit it
The ADP-registered vendor submits the completed form to ADP electronically, bills ADP for its share and charges the applicant the rest. ADP won't fund a hearing aid bought before an ADP authorizer authorizes it.

Good to know

  • Children under 19 must be assessed by an ADP-registered audiologist, who may recommend an otolaryngologist referral for a first application or when hearing isn't stable.
  • Hearing instrument specialists can authorize adult hearing aids but can't prescribe them in Ontario, so a prescription from an audiologist or doctor is still needed.
  • Replacing hearing aids for a change in condition requires a minimum 20 dB loss across 3 speech frequencies; otherwise the device must be worn out and out of warranty.
  • ADP pays 75% of the approved cost up to a maximum, including an earmold bought with the aid. Repairs, maintenance and batteries aren't covered, and a 30-day trial applies.

Get the official form

Download the current version from the source each time; forms change without notice.

Application for Funding Hearing Devices

Demande de financement pour appareils auditifs

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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

What does the prescriber certify on the ADP hearing devices form?

The prescriber, a physician or audiologist, certifies they assessed the applicant in person and that the hearing loss warrants long-term use of a hearing device as part of total daily activities, not exclusively for sports, school or work. Physicians add their six-digit OHIP billing number; audiologists add their college registration number.

Who can authorize ADP funding for hearing aids?

For children under 19, only an audiologist registered with ADP as an authorizer. For adults, an ADP-registered audiologist or hearing instrument specialist. The authorizer tests hearing, selects the make and model, and certifies eligibility, and the device must then be bought from an ADP-registered vendor.

Does ADP cover FM systems for hearing loss?

Yes. The authorizer confirms documented evidence that the applicant or caregiver can use the FM system effectively for basic daily listening. The vendor obtains a signature confirming education and the trial and warranty details, and the authorizer confirms before the trial ends that the system meets the applicant's needs.