Use this form to request a customized device, even if it does not exist yet.

 

This program is available to Illinois residents only.

Minimum delivery time for all custom devices is 2 weeks.

Item Request

Fabricated Assistive Technology

Please provide a title for the device. If the device does not have a name, provide something descriptive.
What will you use the device for?

Maximum file size: 15MB

Main Contact

Customer Information

Same as Main Contact?
*The Maker Program is offered to Illinois residents only.
Terms and Conditions

ELIGIBILITY: By using our website, you warrant that you are 18 years of age or older and have the legal authority to enter into these Terms.
RELEASE OF LIABILITY: I agree to indemnify and hold harmless the Illinois Assistive Technology Program, the IATP Maker Program, and any and all employees, agents or representatives of same, from damages to property or injuries to myself, and/or any other person, and any other losses, damages, expenses, claims, demands, suits and actions by any party against above stated entities, in connection with fabricated devices from IATP Maker Program.
RESPONSIBILITY AND LIABILITY: I understand and agree that I am responsible for the proper handling, storage, use, care, and maintenance of the device(s), component(s), or accessory(ies) given to me hereunder. In the sole discretion of the IATP Maker Program, and any and all employees, agents or representatives of same, my ability to further participate in any such projects, programs, grants, or loans from IATP Maker Program and all of its related programs may be suspended for a period of time or indefinitely for failure to abide by project rules.