2023 Adaptive Grant Form

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2023 Adaptive Grant Form

Are you in need of adaptive equipment? Thanks to a grant funded by Adventist HealthCare Community Partnership fund, we can provide funding for individuals with disabilities in the Washington, DC metro area. If you live in the Washington, DC metro area and need adaptive equipment, apply today. Please fill out the form below.

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Email *

Your email

Please provide your name. *

Your answer

Please provide the date of this submission. *

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What is the type of equipment you need or are requesting? *

Your answer

Do you have a physical disability? *

Your answer

Please provide your address. *

Your answer

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