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ADDRESS:
PO Box 302250
North Harbour
Auckland, New Zealand

FREE PHONE:
0800 31 61 81

PHONE:
+64 9 415 1685

The first choice for mobility and rehabilitation products in New Zealand
online forms / downloads
We have put together some of the more commonly used Allied Medical forms for you to download - and make it even easier for you to deal with us!
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All forms are provided in Adobe Acrobat format.


 

Quick Links to Information on this Page


Trial Request Form

PDF File Click here to use our Online Trial Request Form
PDF File Download the Trial Request Form (43Kb)


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accessable Script Forms

PDF File KM8020/KM8520 Standard Karma Manual Wheelchair (248Kb)
PDF File KP25 Standard Karma Power Chair (227Kb)


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Enable New Zealand Script Forms

PDF File KP25 Script (228Kb)
PDF File Category 1 Karma 8000 (277Kb)
PDF File Script attachment form (36Kb)
PDF File Kimba Spring Enable Script (297Kb)


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Manual Wheelchair Script Forms

PDF File Karma KM8020/KM8520 Standard Manual Wheelchair (248Kb)
PDF File Karma BT10 Self Propelling Bariatric Wheelchair (372Kb)
PDF File Karma 5000 Reclining Wheelchair (58Kb)
PDF File PDG Eclipse 600 Script (391Kb)
PDF File PDG Fuze T20 Wheelchair (392Kb)
PDF File PDG Fuze T50 Wheelchair (391Kb)


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Wheelchair Accessories

Microsoft Excel File Wheelchair Accessories script form (41Kb)


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Children's Wheelchair Script Forms

PDF File Karma KM7520 Standard Paediatric Self Propelling Wheelchair (57Kb)
Microsoft Excel File Otto Bock Eco Buggy (85Kb)
Microsoft Excel File Otto Bock Kimba Spring - Size 1 (114Kb)
Microsoft Excel File Otto Bock Kimba Spring - Size 2 (112Kb)
Microsoft Excel File Otto Bock Kiwi Rehab Buggy (93Kb)
PDF File Otto Bock Skippi Paediatric Powerchair (188Kb)
Microsoft Excel File Otto Bock Teeny Plus Wheelchair (479Kb)


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Power Chair Script Forms

PDF File Quantum R4000 Tilt'n'Space (257 Kb)
PDF File Quantum R400 Vogue Rear Wheel Drive Powerchair (486 Kb)
PDF File Specialty Controls Script (393 Kb)
PDF File Joysticks and Switches Script (204 Kb)
PDF File Quantum Powerchairs (103 Kb)


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Paediatric Rehabilitation

Microsoft Excel File Leckey Advance Bath Chair and Toilet Seat script (76 Kb)
Microsoft Excel File Leckey Squiggles Early Development Script (138 Kb)
Microsoft Excel File Leckey Easy Seat - Potty Trainer script (87 Kb)
Microsoft Excel File Leckey Freestander Script (194 Kb)
Microsoft Excel File Leckey Horizon Stander Script (119 Kb)
PDF File Otto Bock Kit 2010 (1.2 Mb)
PDF File Leckey Mygo Script Form (864 Kb)
Microsoft Excel File Otto Bock Nurmi Neo Walking Aid (99 Kb)
Microsoft Excel File Leckey Pronestander Script (220 Kb)
Microsoft Excel File Leckey Sleepform Script Form (124 Kb)
PDF File Leckey Squiggles Seat Script Form (1.07 Mb)
PDF File Leckey Squiggles Standing Frame Script Form (469 Kb)
Microsoft Excel File Leckey Toilet Seat Script (75Kb)


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End to End Charts

PDF File Backrest Chart (552Kb)
PDF File Cushion Chart (233Kb)
PDF File Manual Wheelchair Chart (180Kb)
PDF File Paediatric Mobility Chart (321Kb)
PDF File Paediatric Standing & Walking End to End Chart (781Kb)
PDF File Powerchair Chart (344Kb)


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Others

PDF File Credit Application Form (63Kb)
PDF File Seat Belt Buckle Guard Prescription Form (82Kb)
PDF File General Guidelines for the Prescriber (49Kb)
PDF File Restraint of Children with Disabilities in Motor Vehicles (51Kb)
PDF File Karma User Manual (1.42Mb)


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The Ringleader

PDF File December 2011 (1.41Mb)
PDF File September 2011 (487Kb)
PDF File June 2011 (683Kb)
PDF File March 2011 (571Kb)

» Ringleader Archive

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ADDRESS PO Box 302250, North Harbour, Auckland, New Zealand
PHONE Call Free: 0800 31 61 81 • Auckland: 415 1685 • International: +649 415 1685
FAX New Zealand: 09 415 1686 • International: +649 415 1686
EMAIL Technicians:techhelp@alliedmedical.co.nz
Customer Care Team: helpis@alliedmedical.co.nz