Please tells us as much as you can about your Wheelchair ...

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

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

Wheelchair Review Form - Download Version

Wheelchair Information
Type of Wheelchair: *
Below are a number of statements about this wheelchair, please tick the options you agree with: *
Below are a number of statements about this wheelchair, please tick the options you agree with:
Please feel free to write more on these topics in the 'Personal Opinion' section further on in this form.
This wheelchair is really comfortable - (Consider how long you can sit in it):
This wheelchair is easy to take apart - (Consider if you can fold it or take parts off to make it smaller):
This wheelchair is easy to transport - (Consider how easy it is to get in and out of a car or WAV):
This wheelchair is easy to use on public transport - (Consider if it can turn in tight spaces like on a bus or train):
This wheelchair is great off road - (Consider if it can go on grass or a bumpy pathway):
This wheelchair can go up or down a kerb/small step - (Consider if this is something it can safely do):
This wheelchair can easily be adapted - (Consider if you have had to make any changes):
Can you hang bags and equipment onto the wheelchair? *
Please feel free to write more on this in the 'Personal Opinion' section further on in this form.
Do you have problems with the wheelchair tipping? *
Please feel free to explain your answer in more detail in the next question.
This question is for powered wheelchairs only!
How did you get this wheelchair? *
Please tell us about the benefits and drawbacks of using this wheelchair. Try to give a detailed description of the different parts, accessories or adaptations the wheelchair may have. Finally, think about how this aid has impacted your quality of life and if you would recommend it to others.
What would you rate this wheelchair? *
Personal Information
Name: *
Name:
Which of the following best describes you: *
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.

 

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