ADP Individual Authorizer Loan Equipment Request

Instructions
  • You must be an Individual Authorizer (OT or SLP).
  • Read this instruction sheet, complete the form below, and select kit (max. 2) or specific items (tick appropriate boxes).
  • Orders are not accepted over the phone.
  • The loan period is three weeks from the date of shipment. Loan extensions are permissible and depend on availability.
  • Failure to return equipment on time impacts your colleagues and their clients. Repeated offenses may result in the removal of loaner privileges.
  • If you have questions please contact mmonteiro@mail.cepp.org
Shipment information
  • Devices are shipped to you at CEP’s expense.
  • Returned equipment expenses are covered by CEP when you attach the Purolator return waybill included with the shipment and call Purolator (1-888-744-7123) for pick up confirming an occupied location.
Receipt Information
  • The packing slip must be signed and faxed to CEP immediately following receipt (416-698-3793). If any equipment is missing please note it on the packing slip.
  • The equipment is your responsibility and shouldn’t be loaned to anyone else.
 Return Information
  • Clean the equipment prior to return.
  • Equipment must include the original packing slip or photocopy.
  • Contact CEP customer service (see shipping information)
Commonly Used Vendors

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ADP Individual Authorizer Loan Equipment Request Form

  • I understand that I can have this device/kit for a period of 3 weeks effective from the date of shipment from CEP. I understand that CEP will cover the cost of shipping if protocols are followed, however if not I will pay the shipping.
  • From
  • To
  • Kit #1 – Simple Speech Generating Devices

  • Kit #2 – Simple Speech Generating Devices

  • Kit #3 – Voice amplifiers

  • Kit #4 – Artificial Larynx

  • Kit #5 – Switch and Device Mounting kit

  • This field is for validation purposes and should be left unchanged.

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