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Welfare for persons with disabilities

Updated: August 23, 2023

It is in PDF file format, so please print it out and use it.
Note: Plain paper is recommended for print paper, and A4 is recommended for print size.
Thermal paper for thermal printers cannot be accepted.

File Download Opens in a new window.Child consultation vote (PDF: 567KB)

File Download Opens in a new window.Child consultation vote writing sample (PDF: 660KB)

File Download Opens in a new window.Child consultation vote (Word: 27KB)

File Download Opens in a new window.Assistive device supply application (under 18 years old) (PDF: 176KB)

File Download Opens in a new window.Assistive device supply application form (18 years old or older) (PDF: 160KB)

File Download Opens in a new window.Physically and mentally handicapped person (child) medical expense subsidy system (maru obstacle) reimbursement payment application (PDF: 138KB)

File Download Opens in a new window.Daily life tool expenses supply application (PDF: 107KB)

File Download Opens in a new window.Stoma appliance, paper diaper supply application (PDF: 105KB)

File Download Opens in a new window.Housing facilities improvement allowance supply application (PDF: 109KB)

File Download Opens in a new window.Nursing Care Benefits/Training Benefits Application Form (Adult) [Double-sided printing] (PDF: 226KB)

File Download Opens in a new window.[Sample] Nursing Care Benefits/Training Benefits Application Form (Adult) (PDF: 392KB)

File Download Opens in a new window.Nursing Care Benefits/Training Benefits Application Form (Children) [Double-sided printing] (PDF: 224KB)

File Download Opens in a new window.[Sample] Nursing Care Benefits/Training Benefits Application Form (Child) (PDF: 384KB)

File Download Opens in a new window.Self-plan style 1-1 (PDF) (PDF: 119KB)

File Download Opens in a new window.Self-plan style 1-2 (PDF) (PDF: 85KB)

File Download Opens in a new window.Self-plan style 1-1 (Excel) (Excel: 24KB)

File Download Opens in a new window.Self-plan style 1-2 (Excel) (Excel: 22KB)

File Download Opens in a new window.Self-plan style 1-1 (entry example) (PDF: 248KB)

File Download Opens in a new window.Self-plan style 1-2 (entry example) (PDF: 145KB)

File Download Opens in a new window.Plan consultation support, child with a disability consultation support request notification form (PDF: 69KB)

File Download Opens in a new window.Situation report (automobile fuel costs (gasoline, etc.) taxi fare benefits) (PDF: 127KB)

File Download Opens in a new window.Receipt attachment paper (automobile fuel expenses (gasoline, etc.) taxi fare benefit) (PDF: 55KB)

File Download Opens in a new window.Situation report (entry example) (PDF: 191KB)

File Download Opens in a new window.Receipt attachment paper (entry example) (PDF: 82KB)

File Download Opens in a new window.Nursing care benefit expenses malpractice petition form (Inagi city style) (Excel: 35KB)

File Download Opens in a new window.Doctor's written opinion (reference style) concerning the use of child tsusho service (PDF: 89KB)

File Download Opens in a new window.Q&A (PDF: 90KB) concerning the use of child tsusho service

File Download Opens in a new window.Positive help care report (PDF: 91KB)

File Download Opens in a new window.[entry example] sunny help care report (PDF: 173KB)

File Download Opens in a new window.Positive help bill (PDF: 83KB)

File Download Opens in a new window.[Entry example] Hidamari help request form (PDF: 326KB)

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If you don't have it, you can download it for free from Adobe.
Get Adobe Acrobat Reader DCDownload Adobe Acrobat Reader DC

Inquiries about this page

Inagi City Welfare Department Disability Welfare Division
2111 Higashi Naganuma, Inagi City, Tokyo
Phone: 042-378-2111 Fax: 042-377-4781

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Disability Welfare Division

  • Welfare for persons with disabilities

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Inagi City Hall

2111 Higashi Naganuma, Inagi City, Tokyo 206-8601
Open agency hours: 8:30 a.m. to 5:00 p.m. Main phone number: 042-378-2111 Fax: 042-377-4781
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