Getting You in a Chair
Our mission: To provide wheelchairs to individuals who do not qualify for other assistance, and who could not obtain such equipment without financial aid.
We understand how important it is to get you mobile and will do everything possible to make that happen. To get started, please follow the application guidelines below. Please take a few minutes to read our Frequently Asked Questions page for more information. If you have further questions feel free to call us at (616) 493-2620.
1. Fill out application for service. (Application must be filled out in its entirety)
Download PDF application (328KB PDF)
Call our office to have application mailed or faxed to your home.
2. Proof of medical need:
Provide prescription or letter of medical necessity from your doctor or physical therapist.
3. Proof of financial need:
Provide proof of annual income and available assets. (Example: Copy of previous year’s tax return, bank statements, annual SSI income, etc…)
4. Denial from insurance:
Provide letter or documentation of denial from your insurance provider if applicable.
5. Seating evaluation:
If you have been evaluated by a doctor, physical therapist, or wheelchair vendor, please provide a copy of their report. (Or any other medical information regarding the size and type of chair being requested)
6. Submit required forms and paperwork:
Email Ron at firstname.lastname@example.org
Alternatives in Motion
201 Matilda NE
Grand Rapids, MI 49503
By Fax: (616) 493-2621