How to Apply for the Incontinence Supplies Grant

On this page:
→ How do I apply?
→ Completing the Application
→ How to apply for higher level funding?
→ Where do I send the application?

How do I apply?

After reviewing the program’s eligibility criteria, you may fill out an Incontinence Supplies Grant Program application and see your child’s Doctor or Nurse Practitioner to fill out their portion.

Please ensure all sections are completed and legible.

Section 1

• Child’s Heath Card and Version Code
• Contact information
• Siblings (provide names of siblings on the Incontinence Supplies Grant)
• Consent to share information (Provide name and contact of a support person/agency whom you would like the program to be able to share information with to support your family.)

Section 2

• Custody documentation (attach legal documents for guardians, crown wards)

Section 3

• Breakdown of incontinence, supplies used and monthly costs
• Physician/Nurse Practitioner section (must be licensed to practice in the province of Ontario and have a valid registration number) must be completed, signed and dated (applications older than 6 months are not accepted)

Section 4

• Breakdown of bowel management supplies used and amounts (if applicable, see grant levels)
• Physician/Nurse Practitioner section (must be licenced to practice in the province of Ontario and have a valid registration number) must be completed, signed and dated (applications older than 6 months are not accepted)

Section 5

• Payee (who the payments are to be made to) can be to the parent/guardian, relative, agency/group home

Section 6

• Authorization must be signed by parent or legal guardian (legal documentation must be provided if you are not the parent)

Section 7

• Direct Deposit option

Completing the Application

1. Enter your information directly on the application or print the application and complete by hand
2. Sign the printed application.
3. If completing the form online, signatures must be an electronic copy of the persons signature as computer generated or digital signatures are not accepted.
4. Take or send your signed application to your Medical Doctor/Nurse Practitioner for review and signature.
5. Once the application is complete send to Easter Seals Ontario via mail, fax or email.
6. Remember to keep a copy for yourself.

If your application is incomplete, it will be returned to you and will delay the application process.

Please allow 6-8 weeks for processing. The grant begins after the application is approved; retroactive payments are not available.

How to apply for higher level funding?

Review eligibility criteria and fill out a Level B increase form if:

• Currently enrolled in the program at Level A
• Child is not physically or developmentally ready to toilet train
• Costs are increasing as child grows out of child-size diapers and you are spending equivalent to or more than $900 per year on diaper supplies/catheters

Applications must be submitted with a minimum of 4 consecutive months of current receipts

• Families who have more than 1 child registered on the program will need to submit receipts for all children registered on the program (requests are assessed on the total expenses)
• Families may remain at Level A and apply for Level B funding if expenses change at anytime in the future
• Level B increase forms do not need to be filled out by a Doctor/Nurse Practitioner
• Approved requests will receive the increase on the next payment cycle (retroactive payments are not available)

Where do I send the application?

Retain a copy for your records. We cannot be responsible for applications that are lost in the mail, returned back to sender or are not legible if submitted electronically.

Send the completed application to:

Mail: Easter Seals Ontario, I.G. Program
700 – 1 Concorde Gate
Toronto, Ontario M3C 3N6
Email: igprogram@easterseals.org
Fax: 416.696.1035

The child’s files are closed when the child is over age 18 years or if:

• There has been no response to a review over 1 year
• Health Card is no longer valid
• Address changes and the program cannot reach you

How to reapply?

If you do not respond to a review request or the file is not active for over a period of 1 year, you will need to reapply for the program.

To reapply you must:

• Complete a new application form (no longer needs to be signed by a Doctor or Nurse Practitioner.)
• Submit a minimum of 4 consecutive months of current receipts to demonstrate how much you are spending on diapers and other incontinence supplies

What if I have more questions?

You can contact the Incontinence Supplies Grant Program at Easter Seals Ontario by:
Email: igprogram@easterseals.org
Phone: 416-510-5074
Fax: 416.696.1035
Mail: Easter Seals Ontario, I.G. Program
700 – 1 Concord Gate
Toronto, Ontario M3C 3N6

Phone Messages: The Incontinence Supplies Grant Program receives a high volume of calls and it may take 2-3 business days to respond to messages. Please ensure you clearly state:

• Child’s name and spell the last name
• Child’s program identification number or Health Card number
• The phone number we can reach you at during business hours, and
• The reason for your call.