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Current Forms

NDAD Client Application
This is the primary application for obtaining assistance from NDAD.

North Dakota Assistive Technology Financial Loan Program
The North Dakota Assistive Financial Loan Program is a program to help North Dakotans with disabilities obtain assistive technology to improve their independence and quality of life.

NDAD Client Application

Version Date:4/1/2004
Description and Instructions:
Please have this application filled out as completely as possible. The Physician Statement of Medical Necessity needs to be completed by your physician. The physician should give details regarding your disability and state that it is their recommendation that the request you have is appropriate and medically necessary.

Also enclose a copy of your most recent income tax return. If you have documentation of the money you have spent on medical expenses this year, enclose copies of these expenses. The processing of your application will begin once all the necessary information is returned to our office. If you have any questions, please contact your local NDAD office.

NDAD Application
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