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Justice Center for the Protection of People with Special Needs

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  3. » Assistive Technology (TRAID) Program
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  5. » Standing Wheelchairs Funding Request Checklist

Sample Supporting Letter of Medical Justification for a Standing Wheelchair

Document: 

Sample_Supporting_Letter_Standing_Wheelchair.pdf

PDF icon Sample_Supporting_Letter_Standing_Wheelchair.pdf

Agency Directory

  • Surrogate Decision-Making Committee (SDMC)
    • Introduction to Surrogate Decision-Making Committee (SDMC)
    • View SDMC Mock Hearing
    • SDMC Forms
      • Forms Needed for Major Medical Treatment
        • Certification on Capacity for Major Medical Treatment (210)
        • Certification on Need for Major Medical Treatment (220A)
        • Declaration for Major Medical Treatment (200)
        • Supplemental Medical Information (220B)
      • Sample Forms Needed for Major Medical Treatment
        • Sample - Declaration for Major Medical Treatment (200)
        • Sample - Certification on Capacity for Major Medical Treatment (210)
        • Sample - Certification on Need for Major Medical Treatment (220A)
        • Sample - Supplemental Medical Information (220B)
      • Forms Needed for End of Life Care
        • Declaration for End of Life Care (300)
        • Certification on Capacity for End of Life Care (310)
        • Attending Physician and Concurring Physician Certification for End of Life Care (320 AB)
        • Supplemental Medical Information (330)
      • Sample Forms Needed for End of Life Care
        • Sample - Declaration for End of Life Care (300)
        • Sample - Certification on Capacity for End of Life Care (310)
        • Sample - Attending and Concurring Physician Certification for End of Life Care (320AB)
        • Sample- Supplemental Medical Information (330)
      • Sample MOLST Checklist with 380-A
    • SDMC Panel Member Handbook
    • Instructions for Opening an Encrypted Email Message from the Justice Center
    • Information for Prospective Volunteer Panelists FAQs
    • Information for Provider Agencies FAQs
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        • Clarification of Reporting and Investigating Deaths
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        • Death Report Form
    • Office of Investigations
      • Death Investigations Unit
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    • Out of State Placements Unit (OSP)
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  • Outreach and Education
    • Adult Home Advocacy
    • Assistive Technology (TRAID) Program
      • AT Funding Toolkits
        • Standing Wheelchairs Funding Request Checklist
          • Sample Letter of Medical Justification for a Standing Wheelchair
          • Sample Supporting Letter of Medical Justification for a Standing Wheelchair
          • Pediatric Power Wheelchair with Accessories
          • Sample Letter of Medical Justification for Pediatric Power Wheelchair
          • Sample Supporting Letter for Medical Justification for Pediatric Power Wheelchair with Accessories
      • AT Training
      • Early Intervention Program Activities
      • Money Follows the Person (MFP)
      • Interagency Partnership on Assistive Technology (IPAT): TRAID Advisory Board
      • TRAID Center Locations by Region
      • getATstuff: Assistive Technology Exchange in New England & New York
    • 2017 Justice Center Code of Conduct
    • Individual and Family Support Unit
      • Contact the Individual and Family Support Unit
      • Reporting and Investigations Process Explained
      • Frequently Asked Questions
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      • Adjudication
      • Administrative Appeals Process Chart
      • Frequently Asked Questions
    • District Attorney Resources
      • Daily Abuse and Neglect Case Advisory
      • Monthly Abuse and Neglect Case Outcome Advisory
      • Instructions for Opening an Encrypted Email Message from the Justice Center
      • Justice Center DA Notifications Webinar
  • Prevention and Quality Improvement

Justice Center for the Protection of People with Special Needs

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