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Application for Exemption or for Re-Evaluation – Contribution by users under the care of intermediate resources
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This form is used to request a change in the financial contribution amount required for an adult being accommodated via an intermediate resource. For instructions for completing the form, use the Guide to the Application for exemption.

Form 4475
Tariff for insured devices which compensate for a motor deficiency and related services, July 1, 2018
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This list was published on June 21, 2018.
Tariff for insured devices which compensate for a motor deficiency and related services, February 14, 2018
/en/media/971
This list was published on February 14, 2018.
Tariff for insured devices which compensate for a motor deficiency and related services, March 1, 2017
/en/media/986
Tariff for insured devices which compensate for a motor deficiency and related services, April 1, 2020
/en/media/8191
This list was published on April 1, 2020.
Notice – Tariff for insured devices which compensate for a motor deficiency and related services, February 14, 2018
/en/media/8251
Notice – Tariff for insured devices which compensate for a motor deficiency and related services, July 1, 2018
/en/media/8256
Notice – Tariff for insured devices which compensate for a motor deficiency and related services, January 1, 2019
/en/media/8261
Notice – Tariff for insured devices which compensate for a motor deficiency and related services, June 1, 2019
/en/media/8266
Notice – Tariff for insured devices which compensate for a motor deficiency and related services, July 1, 2019
/en/media/8271