The following information provides guidance for the short term loan of a Wheelchair in Leeds Teaching Hospitals Occupational Therapy Department.
The following should be explained and demonstrated at hand over.
- Opening and closing the wheelchair
- Folding and unfolding the backrest
- Attaching, detaching and releasing the swinging footplates, leg rests and stump board
- Using elevated leg rests and safety measures (if applicable)
- Releasing and replacing the detachable armrests
- Adjusting the waist belt and how to attach and release the waist belt
- How to apply and release the brakes
- Confirmation the wheelchair is mechanically safe and in good working order
- Confirmation the practical test is satisfactorily completed
The wheelchair is the property of Leeds Teaching Hospitals Occupational Therapy Department
This wheelchair is loaned to you on the conditions below. It should, however, be looked after by yourself as if it were your own property and be protected from damage at all times.
Returning the wheelchair in poor condition may result in having to reimburse the Leeds Teaching Hospitals NHS Trust.
When no longer required or when requested I will return the loaned wheelchair, cushion and accessories to the address printed below. This will be in the condition in which I received it (fair wear and tear accepted).
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It is your responsibility to keep the wheelchair clean and in good working order.
Ensure the wheelchair will not be used or loaned to anyone else.
You will not adjust or have any attachments fitted to the wheelchair without prior agreement from the Occupational Therapy department.
You will be required to sign as a patient, carer patient or guardian to say you accept these conditions, this will be counter signed by the member of staff issuing the equipment.
