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Quick Links to Information on this Page

• Trial Request Form
• accessable Script Forms
• Enable New Zealand Script Forms
• Wheelchair Script Forms
• Children's Wheelchair Script Forms
• Power Chair Script Forms
• Paediatric Rehabilitiation
• End to End Charts
• Other
• The Ringleader

Trial Request Form

Click here to use our Online Trial Request Form

Download the Trial Request Form (56Kb)

accessable Script Forms

KM8020/KM8520 Standard Karma Manual Wheelchair (247Kb)

KP25 Standard Karma Power Chair (226Kb)

Quantum 600 (324Kb)

Enable New Zealand Script Forms

Accessories form (65Kb)

Enable Category 1 Karma 8000 (249Kb)

Enable Category 3 Karma KP25 (227Kb)

Enable Category 3 Jazzy 600 (274Kb)

Enable Category 4 Jazzy 600 Tilt 'n' Space (273Kb)

Enable Category 4 Quantum-Dynamo 1107 Tilt 'n' Space (288Kb)

Enable Category 3 Quantum Dynamo 1107 non-tilt (259Kb)

Enable Category 5 Quantum-Dynamo 1107 Tilt 'n' Space (267Kb)

Enable Category 5 Quantum 600 Tilt 'n' Space (296Kb)

Enable Buggy Kimba Spring (166Kb)

Enable Category 5 Specialty Controls (210Kb)

Script attachment form (36Kb)

Wheelchair Script Forms

KM8020/KM8520 Standard Karma Manual Wheelchair (68Kb)

KM7520 Karma Paediatric Wheelchair (57Kb)

Karma 5000 Reclining Wheelchair (60Kb)

PDG Fuze T20 Tilt-in-space Manual Wheelchair (121Kb)

PDG Fuze T50 Tilt-in-space Manual Wheelchair (121Kb)

PDG Eclipse 600 Heavy Duty Bariatric Manual Wheelchair (121Kb)

Wheelchair Accessories

Wheelchair Accessories script form (61Kb)

Children's Wheelchair Script Forms

Gizmo Tilt (498Kb)

Karma KM7520 Standard Lightweight Paediatric Self Propelling Wheelchair (57Kb)

Otto Bock Minny Wheelchair (318Kb)

Otto Bock Eco Buggy (189Kb)

Otto Bock Kimba Spring - Size 1 (155Kb)

Otto Bock Kimba Spring - Size 2 (153Kb)

Otto Bock Start Junior (175Kb)

Otto Bock Teeny Plus Wheelchair (822Kb)

Power Chair Script Forms

Accessories form (88Kb)

KP25 Standard Karma Power Chair (67Kb)

Q600 Non-tilt (268Kb)

Quantum 610 Non-tilt (141Kb)

Quantum 610 Tilt-in-space (190Kb)

Quantum 6000 Non-tilt (298Kb)

Quantum 6000Z Non-tilt (146Kb)

Quantum 6000Z Tilt-in-space(205Kb)

Quantum 1420 Tilt'n'Space (Q-Logic) (282Kb)

Quantum 1420 Non-tilt (388Kb)

Quantum R4000 Non-tilt (283Kb)

Quantum R4000 Tilt'n'Space (281Kb)

Script attachment form (36Kb)

Specialty Controls script (240Kb)

Paediatric Rehabilitation

Leckey Advance Bath Chair and Toilet Seat script (175Kb)

Leckey Advance Seating Script Form (225Kb)

Leckey Easy Seat - Potty Trainer script (263Kb)

Leckey Freestander Script(220Kb)

Leckey Horizon Stander Script(145Kb)

Leckey Mygo Script Form (162Kb)

Leckey Pronestander Script(246Kb)

Leckey Sleepform Script Form (157Kb)

Leckey Squiggles Seat Script Form (163Kb)

Leckey Squiggles Standing Frame Script Form (58Kb)

End to End Charts

Cushion End to End Chart (233Kb)

End to End Backrest Chart (771Kb)

Powerchair End to End Chart (240Kb)

Paediatric Mobility End to End Chart (1.02Mb)

Paediatric Standing & Walking End to End Chart (784Kb)

Others

Credit Application Form (63Kb)

Seat Belt Buckle Guard Prescription Form (82Kb)

General Guidelines for the Prescriber (49Kb)

Restraint of Children with Disabilities in Motor Vehicles (51Kb)

Karma User Manual (1.42Mb)

The Ringleader

April 2010 (1Mb)

December 2009 (1.31Mb)

August 2009 (345Kb)

May 2009 (344Kb)

August 2008 (365Kb)

December 2007 (1.67 Mb)

September 2007 (174Kb)

June 2007 (184Kb)

January 2007 (210Kb)

September 2006 (387Kb)

June 2006 (344Kb)

February 2006 (673Kb)

November 2005 (928Kb)