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Manitoba Wheelchair Program 1857 Notre Dame Avenue, Winnipeg, Manitoba R3E 3E7 Phone (204) 9753250 Fax (204) 9753240 Toll Free 18008365551RENTAL APPLICATION NIB FUNDED CLIENTS ONLY Note: Illegible
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How to fill out manual wheelchair application

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How to fill out manual wheelchair application

01
Contact your doctor or healthcare provider to discuss the need for a manual wheelchair.
02
Obtain a prescription or recommendation from your doctor for a manual wheelchair.
03
Contact your insurance provider to inquire about coverage for a manual wheelchair.
04
Obtain the necessary paperwork from your insurance provider or the wheelchair supplier.
05
Fill out the application form with accurate and detailed information, including your personal details, doctor's recommendation, and insurance information.
06
Submit the completed application form along with any required documentation to the appropriate party for review and approval.

Who needs manual wheelchair application?

01
Individuals with physical disabilities or mobility impairments who require assistance with mobility.
02
Patients recovering from surgery or injury who need temporary mobility assistance.
03
Elderly individuals with mobility issues who need support for daily activities.
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Manual wheelchair application is a form used to request a manual wheelchair for individuals who need assistance with mobility.
Individuals who require a manual wheelchair for mobility purposes are required to file the application.
The application can be filled out online or in person by providing personal information, medical history, and reason for needing a manual wheelchair.
The purpose of the application is to assess the need for a manual wheelchair and provide the necessary assistance to individuals with mobility limitations.
Personal information, medical history, doctor's recommendation, and mobility limitations must be reported on the application.
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