Fill your part of the ADP adult insulin pump application, fast

The Assistive Devices Program helps eligible adults with Type 1 diabetes access an insulin pump and supplies, and the application splits across an applicant section, an authorizer section, and a vendor section. This guide is an example of storing your details in hivi so your part is ready in seconds.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Assistive Devices Program — ontario.ca
• Form (Central Forms Repository): Application for Funding Insulin Pumps and Supplies for Adults — 014-4537-67

What this form is about

The ADP insulin pump funding application for adults asks for confirmation of your identity and health number alongside clinical detail from a registered authorizer and device information from your vendor. Approved applicants receive funding toward their pump and ongoing supplies.

Before you start: what to gather (your section)

• Your full legal name and current Ontario address.
• Your Ontario health number.

Confirm current eligibility criteria and documentation requirements on ontario.ca before submitting.

How hivi makes it faster

1. Store your details once. Add your name, address, and health number to hivi — the same core identity information used across virtually every Ontario health program form.
2. Autofill your section. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
3. Authorizer and vendor complete their sections. Those parts require a registered ADP authorizer and your pump vendor.
4. Review and submit the completed form to the Ministry of Health.

Why do it in hivi

Insulin pump renewals, supply applications, and related ADP forms all ask for the same applicant details. Stored once in hivi — in Canada, with self-hosted AI — each application starts mostly filled and ready to verify.