Please tells us as much as you can about any Attachment, Accessory or Additional Part you use with your Wheelchair or Scooter...

*  This sign means that we need you to fill these sections in! *


If you would like to take your time with your review, simply click the link below to download this form and email it back to us!

Attachment & Accessory Form - Download Version

Attachment or Accessory Information
Type of Attachment or Accessory: *
Below are a number of statements about your attachment or accessory, please tick the options you agree with: *
Below are a number of statements about your attachment or accessory, please tick the options you agree with:
This item makes me more comfortable - (Consider how it makes you feel when using your wheelchair or scooter):
This item is easy to transport - (Consider how easy it is to get in and out of a car or WAV):
This item is great off road - (Consider if you can use this item when travelling on grass or a bumpy pathway):
This item can easily be adapted - (Consider if you have had to make any changes):
This question is only for items that are powered by a battery!
How did you get this attachment or accessory? *
Please tell us about the benefits and drawbacks of using this item. Finally, think about how this item has impacted your quality of life and if you would recommend it to others.
What would you rate this Attachment, Additional Part or Accessory? *
Personal Information
Name: *
Name:
Please select the fields you are happy for us to publish with your review: *
Terms and Conditions: Privacy Policy *
You can read our Terms & Conditions by clicking on the link above! Please let us know if you have read and understood AYL'S Privacy Policy. Don't worry if you do not understand, simply contact us for more information before submitting your review.