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.
- If you are a case worker or advocate, please ensure that your client lives in our service area and can meet the above requirements before filling out this form on their behalf. Thank you.