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Ontario ADP Communication Aids Application (4825-67E)

Ontario's Assistive Devices Program uses this application to fund communication aids, such as speech generating devices, electrolarynges, voice amplifiers, writing aids and access hardware, for people with a long-term physical disability who need the aid for six months or longer. An ADP-registered authorizer assesses the person and selects the device. ADP pays 75% of the approved price, or 100% for people on social assistance.

Who completes it

A physician or nurse practitioner enters the diagnosis in Section 2 and signs Section 4, certifying a chronic physical disability requiring regular use of the aid. The ADP-registered authorizer selects the devices and signs, the applicant or agent signs Section 3, and the vendor certifies the items supplied.

Submitting and payment

How to submit it
The form goes to ADP once the applicant, authorizer, prescriber and vendor have signed, and ADP doesn't consider attachments. When buying from a non-registered vendor, the applicant pays in full and submits the form within one year of the authorizer's assessment date.

Good to know

  • A speech-language pathologist authorizes speech aids and an occupational therapist authorizes writing aids; high-technology devices and display boards need an ADP designated communication clinic.
  • ADP excludes aids used only for school, work or recreation, environmental control units, telephones, items bought outside Ontario, and used equipment outside an ADP equipment pool.
  • For a replacement because the medical condition changed, the physician or nurse practitioner must confirm the change and complete the applicable sections of a new form.
  • ADP doesn't pay for repairs or maintenance, except on leased devices, and won't replace equipment that is lost, stolen or damaged through misuse.

Get the official form

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

Application for Funding Communication Aids

Demande de financement Aides à la communication

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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.

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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

When must a physician or nurse practitioner sign the ADP communication aids form?

First-time applicants must be seen by a physician or nurse practitioner, and replacements because of a changed medical condition also need one. The clinician records the diagnosis and certifies a chronic physical disability requiring regular use of the prescribed aid, and may refer the person to an ADP-registered authorizer.

How much does ADP pay for a communication aid?

ADP pays 75% of its approved price and the applicant pays 25%, or ADP pays 100% for people receiving Ontario Works, ODSP or Assistance to Children with Severe Disabilities when the device is authorized. Voice restoration and speaking valves are funded from the vendor's price up to a maximum over three years. Non-funded options cost extra.

Who is eligible for ADP communication aid funding?

Ontario residents with a valid health card in their own name and a long-term physical disability that requires a communication aid for six months or longer. ADP doesn't fund equipment available through the WSIB, or to Group A veterans for their pensioned conditions, and an ADP-registered authorizer's assessment confirms eligibility.