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Assistive Devices Program (ADP) Application Form

BoundlessBracing_ADPform.png
BoundlessBracing_ADPform.png

Assistive Devices Program (ADP) Application Form

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The Assisitive Devices Program (ADP) form must be completed by a physician or RPN. The original completed ADP form must be received by Boundless Biomechanical Bracing. Boundless Biomechanical Bracing is an registered vendor. All of Boundless’ Certified Orthotists are registered authorizers. Boundless will submit this application form on behalf of the patient.

Sections which must be completed by the physician or RNP are:

Section 2: Diagnosis

Section 4: Signatures

This form is also accessible through the Ministry of Health and Long-Term Care online.

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