Before starting or completing an application please review and carefully read the Quality of Life Equipment Program Guidelines
found on the MS Society website. This application can be used to apply for new or used equipment, repairs and cooling products (Air Conditioning).
You may begin and save your progress on the application at any time, by using the save function located at the top of the page. To submit your application, all fields marked with an asterisk (*) must be completed; incomplete sections will prevent the application from being submitted. Please ensure you’ve uploaded all supporting documentation, including the Heath Care Professional Assessment and Vendor Quotes.
Should you have any questions about the application or program, or are experiencing issues with the application, please contact an MS Navigator at 1-844-859-6789 or firstname.lastname@example.org