Disability Application Form Template

This disability application form template may be used by any government agency that issues disability benefits for those in need. To modify this disability application form, all you need is a 123FormBuilder account. No coding involved.

AVAILABLE ON GOLD PLAN

This template is available in the GOLD plan, with many perks:

Unlimited question fields
5.000 submissions per month
Collect files
Email & SMS notifications
Third-party integrations
Visual reports

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Customize template

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This template comes in handy for disabled people who need to claim damages or other benefits. Make sure you customize it to fit your organization by using the simple drag & drop editor from our platform. Many configuring options are available, for example setting up an autoresponder so that applicants rest assured their claim is up for review.

Publish template

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When you're ready to begin collecting disability requests, all you have to do is copy and paste. Embed the form into a website, include the URL in an email, or share in a group on a social network. The form is mobile optimized, so it can be completed just about anywhere.

Collect & manage data

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Processing disability applications is both easy and safe with our online forms. All requests live together in a secure database. It’s an intuitive interface that monitors everything at once to make sure all the applications are reviewed. You can also create downloadable charts and graphs for reporting purposes.

Optimize your flow

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A disabled person is entitled to benefits and support, and this includes an easy method of applying for social and monetary support. Provide your organization with a digital disability claim form that sends instant notifications whenever requests come in.