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Caresinc.org Phone 1-800-773-7055 Fax 207-377-7057 DEVICE LOAN REQUEST FORM Name County Resides Phone Address Age of the individual with a disability who will use the AT check one Under 3 3-20 21-55 Over 55 Types of Participants Borrowing AT Number of Borrowers Individuals with disabilities Family member guardian or authorized representative Representative of Education Total Type of AT Device Loaned Number Loaned Vision Hearing Speech communication Learning cognition and developmental...
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Individuals with disabilities or medical conditions that require special care and assistance may benefit from cares incadvocacy and assistive services. These services can help them navigate various systems and access the support they need.
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Cares Incadvocacy and assistive is a program that provides advocacy and assistive services to individuals in need.
Individuals who are eligible for the program and require advocacy and assistive services are required to file for cares incadvocacy.
To fill out cares incadvocacy and assistive, individuals must provide their personal information, details of their needs, and any relevant documentation.
The purpose of cares incadvocacy and assistive is to ensure that individuals in need receive the necessary advocacy and assistive services to improve their quality of life.
Information such as personal details, medical history, specific needs, and contact information must be reported on cares incadvocacy and assistive forms.
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