How to Apply for Payment
Assistance
This process is to help veterans and service members submit
an application to help pay for medically necessary
improvements and alterations to essential lavatory and
sanitary facilities in their primary residence.
© Copyright 2024 Nordic Plumbing 906
Website by North Country Website Design
Service Offerings
Emergency Repairs Barrier-Free Bathrooms Bathrooms Kitchens Repairs Handyman ServicesContact
Tel: 906.239.0602 Email: info@nordicplumbing906.com Mailing Address: 736 Lake Shore Dr. Escanaba, MI 49829
When the VA medical center sends you a prescription for Home Improvement and Structural Alterations (HISA) program you need to do the following:
1.
A completed and signed VA Form 10-0103, Veterans application for Assistance in Acquiring Home Improvements and Structural Alterations at www.va.gov/forms.
a.
Click here for VA Form 10-0103.
2.
An itemized estimate of costs for labor, materials, permits and inspections. Andy will provide this for you.
3.
A color photo of the unimproved area.
4.
If you are a renter, a notarized statement from the landlord authorizing the HISA project.
5.
A completed Direct Deposit Enrollment Form, which will come with your prescription.
Andy will not start any modification/adaptions to your home until you have been notified by the Department of Veteran Affairs that your project was approved. A pre-
approval inspection may be required. If you have any questions or issues about your HISA application, please contact your locl Prosthetic Services at phone number 1-
800-215-8262 ext. 32873.
How to Apply for
Payment
Assistance
This process is to help veterans and
service members submit an application to
help pay for medically necessary
improvements and alterations to essential
lavatory and sanitary facilities in their
primary residence.
© Copyright 2024 Nordic Plumbing 906
Website by North Country Website Design
Service Offerings
Emergency Repairs Barrier-Free Bathrooms Bathrooms Kitchens Repairs Handyman ServicesContact
Tel: 906.239.0602 Email: info@nordicplumbing906.com Mailing Address: 736 Lake Shore Dr. Escanaba, MI 49829
When the VA medical center sends you a
prescription for Home Improvement and Structural
Alterations (HISA) program you need to do the
following:
1.
A completed and signed VA Form 10-0103,
Veterans application for Assistance in Acquiring
Home Improvements and Structural Alterations
at www.va.gov/forms.
a.
Click here for VA Form 10-0103.
2.
An itemized estimate of costs for labor,
materials, permits and inspections. Andy will
provide this for you.
3.
A color photo of the unimproved area.
4.
If you are a renter, a notarized statement from
the landlord authorizing the HISA project.
5.
A completed Direct Deposit Enrollment Form,
which will come with your prescription.
Andy will not start any modification/adaptions to
your home until you have been notified by the
Department of Veteran Affairs that your project was
approved. A pre-approval inspection may be required.
If you have any questions or issues about your HISA
application, please contact your locl Prosthetic
Services at phone number 1-800-215-8262 ext.
32873.
