Appointment Booking

YOUR DETAILS









CLIENT DETAILS












Client Measurements







Client Measurement



Wheelchair details

(Note: this is only relevant if its an appointment for a wheelchair)

Wheelchair type:

Self propelledTilt in spaceManualMotorisedUser on right

Controls:

User on leftAttendent on rightAttendent on leftUser on the right

Setup:



LateralsPommelHip guidesPower add on

Preferred Appointment date and time


2nd Preferred Appointment date and time