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 usually have a 3- to 6-month wait for folding/portable electric wheelchairs and scooters. Non-portable devices may be available more quickly.
- Due to cost and volunteer availability, we can only deliver non-portable power mobility devices to Monroe, Owen, Greene, Lawrence, Brown, or Morgan County. Residents of other counties are only eligible to receive a device if they can come to our office or send someone to pick up the device at our office. No exceptions.
- Portable/folding mobility devices must be picked up at our office, so we can make sure you/your family member can load it into your vehicle.
As of 1/25/26, MALL requires that all power mobility requests be made by one of the following:
- The person who needs the device.
- A family member or friend who lives near the person and understands their needs.
- A local medical/social service professional who has in-person knowledge of the client and their needs.
- If you are from a national agency such as Solace Health that does not work with clients in person, you must send this page to your client/family and have them complete the form themselves. All arrangements will then be made directly with the client/family.