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12 questions
Please select the correct answer: This type of wheelchair can be folded.
Manual Wheelchair
Manual Scooter
Electric Wheelchair
Manual Walker
Please select the correct answer: If the member is using a manual wheelchair we must ask?
Are you able to transfer without assistance ?
Are you able to walk?
Are you able to ambulate?
Are you able to sit in the seat?
Please select the correct answer: Transfer means the member is able to?
Stand and put own wheelchair in the back
Stand and get dressed alone
Stand and get into vehicle and fasten seat belt
Move from one place to another
Please select the correct answer: "EWC" is the approved abbreviation for?
Electric Wind Chair
Electric Water Chair
Electric Wheeled Scooter
Electric Wheelchair
Please select the correct answer: If the member is in an MWC and able to transfer what is the LOS?
Wheelchair
Stretcher
Ambulatory
Basic Life Support
Please select the correct answer: CSRs must ask all wheelchair level of service members for their?
Weight and height
If there is a ramp or steps
If the chair has leg rests
If the chair has arm rests
Please select the correct answer: If the member has steps to exit their home, can they travel by Wheelchair?
Yes
No
Please select the correct answer: Can an electric wheelchair be folded?
Yes
No
Please select the correct answer: What field in LCAD would you notate if the member has a ramp at their residence.
TP comments
DIR field
Condition Field
TP Field
Please select the correct answer: If the member states that they have an electric wheelchair, we will also ask the member if they have?
Leg rest
Arm Rest
portable ramp
Manual Wheelchair
If the Member is able to transfer from a manual wheelchair, where would you enter "MWC/able to transfer"?
Dir Field
Trip Notes
Condition field
TP Comments
A level of service upgrade to Wheelchair for an escort can only be done when..
the Member states they do not feel like walking.
the escort is required (i.e. parent traveling with a minor) .
the cow jumps over the moon.
the health of the Member will deteriorate if they are not provided the appropriate equipment.
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