	Wheelchair & Mobility Scooter Parts and Accessories 5% Off For Visiting USA TechGuide or United Spinal's MS Scene website.
	HONEST!

Wheelchair Medic promises you Honest prices and Honest service. We have been doing business this way for over 30 years.

Please fill out the form to get a parts price quote. All price quotes will indicate a 5% discount for being a USA TechGuide or United Spinal's MS Scene visitor. You must use this form to receive the discount.

Please be advised: We can not assist you in diagnosing or troubleshooting your wheelchair or mobility scooter. Due to the sophisticated nature of these devices, diagnostics are not possible without inspection.

Fields preceeded with "*" must be completed. We will process and rreply to your request promptly.

Thank you for choosing Wheelchair Medic for your wheelchair and scooter needs.

Your personal information

* Your email address:

Title:

* First Name:

* Last Name:

Your location: Needed to accurately determine shipping charges

* Address 1:

Address 2:

* State:

* City:

* Postal/Zip Code:

Your wheelchair or scooter information. We will contact you if more information is required.

* Product make and model:

Enter the manufacturer's name and the model.

Product serial number:

Enter the product serial number if you know it.

* Describe part(s):

Comments:

* Enter the security code shown:

Do not include spaces.

Wheelchair Medic
Bldg. 102 Duane Rd.
Fort Totten, NY 11359
718.352.1623

Wheelchair Medic is a division of
United Spinal Association
www.unitedspinal.org