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Teacher Helping Student

If you are in need of fall prevention home modification services (grab bars, bathroom assistance devices, a wheelchair ramp, etc.) please click the online application button below. Proof of income can be uploaded to the online application.

Proof of Income Documentation for Each Household Member:

  • Bank statements from the previous three months

  • Income Tax Return from the previous year (If filed)

  • Social security or disability award/determination letter, OR three most recent payroll check stubs

(Don't forget to block out social security and bank account numbers)​

En Espanol:

Si necesita servicios de modificación del hogar para la prevención de caídas (barras de apoyo, dispositivos de asistencia en el baño, una rampa para la silla de ruedas, etc.), haga clic a continuación para descargar una solicitud.

Para la aplicación en español, haga clic aquí.

To Submit Documents by Mail or Email:

1826 W. Broadway Rd., Ste. 16

Mesa, AZ 85202

clientservices@rtvos.org