child with assistive technology in a field

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Please see below for the contact information of our four locations!

Hampton Roads & Roanoke

ATN: Linda Dew
900 Granby Street, Suite 138
Norfolk, VA 23510

hr@atdevicesforkids.org(757) 763-8905

ATN: Maggie Forbes
5568 Airport Road
Roanoke, VA 24012

roa@atdevicesforkids.org(540) 493-2285

Richmond &
Northern Virginia

ATN: Monica Beach
2545 Gayton Centre Dr.
Richmond VA 23238

rva@atdevicesforkids.org(540) 420-0554

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Our Sponsors

C.A.T.S. provides for the re-use of pediatric rehabilitation equipment and assistive technology devices in Virginia. We serve as a no-cost resource for children with disabilities who need adaptive equipment and whose families have limited resources.

EIN

a 501(c)3 public charity
EIN: 46-4866068

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Parent/Guardian Info

Parent/Guardian Name
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Therapist Info

Therapist Name
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Child Info

Child Name
Race
Age
Height
Weight

Other Info

Why did you choose to obtain an AT device/service from our program?
What type of insurance does the child have?
Has the requested equipment been denied by Insurance?
Persons in Household
Family Income Range
Is this child currently a client of the Department of Aging and Rehabilitative Services (DARS)?
Diagnosis
The primary reason for which the child and family needs an AT device or service is related to:
Will equipment be used at home, school or both?
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Please Note:

The fields above are required to complete your equipment request. We also require a signed Equipment Release Form to process your request. Please sign the Equipment Release Form at the button below.

Required Equipment Release Form
Liberación de Equipo

Equipment Release

Please Read and Sign before submitting your request.

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