Caregiver-Helpline

EZ-ACCESS Ramp Worksheet

This sheet is provided for your convenience in helping you and your dealer in selecting the correct ramp for your needs. Please print this worksheet, fill out as complete as you can, and take it with you to your local dealer. If you need assistance in filling out this form, contact one of our dealers. A local dealer can be found on our dealer search page. If you cannot find a dealer on this listing, you can fill out our inquiry form and we will be happy to send you a list for your area. If you are purchasing a ramp for stairs that are awkwardly staggered, please have all dimensions available.

What is the PRIMARY use for this ramp: (Home/Vehicle/Other) _______________________

Will the ramp be moved often or left down in one location? __________________________

Is the ramp going to be used with a scooter or with a wheelchair?_____________________

How much ground clearance do you have? (Measure distance from the battery pack or foot rests to the floor) ___________

What is the weight of the chair with and without the occupant? _______________________

FOR USE WITH STAIRS:

If you are planning on using the ramp for stairs, are they uniform steps (1) or staggered (2)? (See picture)

Uniform Steps
Staggered Steps


What is the height ________________ and depth of each step?_____________________

Are there any landings (similar to picture 2)? What is the depth? _____________________

How much room do you have after the last (bottom) step? (ie; length of walkway) _________

FOR VAN/AUTO USE:

For van use, will you be loading through the side or back of the vehicle? ________________

What is the distance from the floor of the van/trunk of the car to the ground?______________

Will the occupant be riding the wheelchair into the vehicle? __________________________

What is the width of the door opening? _________________________________________

How much room do you have to store the ramp in the vehicle? _______________________

Copyright 2008 Caregiver-Helpline, LLC All Rights Reserved.