Customer wheelchair information

Which parts fold or collapse (if applicable)?

Are there any removable parts (e.g., foot rests, seat cushions, etc.)?

Yes (list below) No If yes, please enter the list of removeable parts

Will you bring any parts of the chair into the aircraft cabin?

Yes (list below) No If yes, please enter any parts of the chair you plan to bring into the aircraft cabin

Are any tools required?

Yes (List and briefly describe function.) No If yes, list tools and briefly describe their function

Note: Please provide airport personnel with any tools required to fold or dismantle your wheelchair

Special instructions or precautions including how to deactivate/reactivate the battery:

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