Request a Free Electric Wheelchair or Mobility Scooter

Specialized Mobility Equipment Request

Use this form if you need a mobility scooter, electric wheelchair, Hoyer lift/hoist, or other high-tech electronic equipment. These items require a phone consultation with MALL staff before we can schedule a pickup. Please note: We almost always have regular power wheelchairs such as Jazzy, Permobil, and Quantum in stock. Some have seat elevators, tilt, recline, and other great features! However, we usually have a 3- to 6-month wait for folding/portable electric wheelchairs and scooters. Click here to learn about our waiting list.