Equipment We provide mobility equipment which is not usually available on the NHS such as powered wheelchairs and trikes for disabled children and young people up to the age of 26. Please read the following guidance notes before downloading and completing the form. WHO CAN APPLY? We welcome applications from or on behalf of children or young people up to and including age 25 who need specialist mobility equipment or a wheelchair to help them become more independent. The child or young person must be resident in the UK. WHAT YOU CAN APPLY FOR We can supply powered, manual and sports wheelchairs. We can also fund other mobility equipment for specific purposes: specialist trikes, scooters, buggies, walkers, car seats etc. This list is not exhaustive and if you are unsure please phone our Mobility Services Team on 020 8347 8111 or email email@example.com We will only provide aids that are not normally available through the NHS. Wherever possible we ask Wheelchair Services to provide vouchers towards chairs. HOW DOES IT WORK? We provide aids in one of two ways depending on the type of equipment. Powered wheelchairs are usually supplied on a permanent loan basis. This means that they remain the property of Action For Kids who will then be responsible for repairs and maintenance. Other types of equipment are the property of the family or individual. We will not consider funding for equipment that has been purchased already. We encourage part funding with other charities and welcome contributions from families’ own fundraising efforts. HOW DO I APPLY? Please read this information carefully before completing your form. If you are a parent or carer please try (where possible) to complete this application form together with the child or young person who will be using the equipment, particularly when answering questions about their life experiences or interests. Please complete all sections of the application so that we can get a clear picture of your situation and needs. This application form is an agreement between the recipient’s family and Action For Kids and by signing it you are agreeing to abide by our Terms and Conditions (see P9). It is important, therefore, that you read them carefully before signing and returning your application. Step 1 Before applying to us you will need to arrange an assessment for your child with a representative of the equipment supplier and an occupational therapist or physiotherapist. Assessments can usually take place at home or in school. The supplier will provide you with a price quotation for the equipment you want and the physiotherapist or occupational therapist should provide you with a letter setting out why your child needs this piece of equipment and the functions it offers. For equipment costing more than £1,500 we ask you to send us two quotations for different makes/brands offering similar functions, regardless of whether you are contributing to the cost of the equipment. This may involve the applicant having two assessments. However, there are several companies that provide chairs from a range of brands. For example, if you are seeking funding for a chair with sit to stand features you could contact a supplier such as Midshires Group who provide many brands of wheelchairs. They can come to the applicant’s home with a couple of chairs or more that might meet their needs, thereby undertaking an assessment and providing two quotes in just one visit. Midshires are at www.midshiresgroup.co.uk on 01889582332. There are other companies that offer a similar assessment process such as Gerald Simonds at www.gerald-simonds.co.uk on 0800 220975. For specialist trikes, Action for Kids works closely with Theraplay Trikes (the preferred provider for a range of charities). We often like one of the quotes to come from Theraplay, say if the applicant has already had an assessment with Quest 88 or Tomcat. Theraplay is at www.Theraplay.co.uk on 0141 8769177. Action for Kids usually funds the cheaper of the two pieces of equipment, unless the therapist confirms that it does not meet the applicants’ needs. Step 2 Complete the application form. If you have any questions, please contact our Mobility Services team on 020 8347 8111 or via firstname.lastname@example.org During 2017 our waiting list for equipment can be up to nine months or sometimes a little longer. We do hope to shorten the time, particularly for items under £1000. A wait for a powerchair can be up to eighteen months or even a little longer. Step 3 Return the completed application form together with the quotation/s and the therapist’s supporting letter, as well as a photograph of your child/young person. You can return these by scanning and e-mailing them as separate documents to: email@example.com Or post them to: Mobility Services Action For Kids 15a Tottenham Lane DOWNLOAD THE APPLICATION FORM TO FILL IN BY HAND HERE. DOWNLOAD THE APPLICATION FORM TO FILL IN ON YOUR COMPUTER HERE.