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CLIENT DETAILS
MODIFICATIONS REQUIRED
Tick which type you are interested in.
WHEELCHAIR DIMENSIONS
Remove the cushion and fold the backrest down before measuring D2. The guides below show where each measurement is taken.
VEHICLE INFORMATION
Your current vehicle, if you have one.
The vehicle you would prefer.
PHOTOS OF YOUR WHEELCHAIR
Please include a front, side and back photo with the backrest folded down and the cushion off. Up to 6 photos, JPEG or PNG, 8MB each.
ADDITIONAL COMMENTS
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