Get Permobil Order Forms

Filling out the Permobil Order Forms online is a critical step in ensuring that a person receives the right mobility equipment. This guide provides clear and comprehensive instructions to help you navigate each section of the form efficiently.

Follow the steps to smoothly complete the form.

1. Click the ‘Get Form’ button to access the Permobil Order Forms and open it in your preferred editor.
2. Begin with the Dealer Information section. Fill in the required fields such as ATP, Dealer Code, and Dealer Name. Ensure all necessary information is accurate.
3. Proceed to the Client Information section. Enter the client's first and last names along with their diagnosis, funding source, and age. Always prioritize accurate and concise entries.
4. Next, fill out the Client Measurements section, providing details on weight, height, and various body measurements as specified. Note that measurements marked with an asterisk are mandatory.
5. In the Chair Model and Colors section, select the preferred base, wheel package, shroud color, hubcap color, and any optional drive tires. Ensure you understand the implications of each selection.
6. Continue to the seating options, where you must specify the seat function control type and any additional features. Follow the prompts to select the desired options that suit the client's needs.
7. Complete any additional sections related to seating, armrests, legrests, and accessories by selecting the desired options, and adding any notes regarding customizations.
8. Finally, ensure you complete the order policy section. Sign and date the order acknowledgment and confirm that all information is accurate before submitting.
9. At the end of the process, save your changes, and download or print the completed form for your records. You can also share the form if necessary.

Complete your Permobil Order Forms online today to ensure timely processing and delivery.