File name: Illinois Power Scooter Assessment Form Pdf
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👉Illinois Power Scooter Assessment Form Pdf
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Online Customers Support · % Money Back GuaranteeTypes: Affidavits, Bills of Sale, Contracts, LLC Formation, Real Estate. Blue Cross and Blue Shield of Illinois (BCBSIL) reviews requests for manual wheelchairs (MWCs) and power-operated vehicles (POVs) (i.e., Power Wheelchair, Scooter, Other POV) as . Mar 29, · Blue Cross and Blue Shield of Illinois (BCBSIL) reviews requests for manual wheelchairs (MWCs) and power-operated vehicles (POVs) (i.e., Power Wheelchair, Scooter, . Safety Assessment for Motorized Scooters and Electric Wheelchairs Five criteria for assessment are: 1. Move safely in and out of vehicle 2. Demonstrate safe reaction times - does not hit walls/people 3. Be able to take appropriate evasive action when sudden objects are in driver’s pathway 4. Turn the vehicle around safely 5. The Prior Approval Unit handles durable medical equipment, therapeutic supplies, mobility devices, therapies, home health, and bariatric surgery request for the Illinois Department of Health Care & Family Services. Scooter Power w/c M w/ tilt P w/ seat elevator P w/ stand None CURRENT MOBILITY ASSISTIVE EQUIPMENT (MAE) / SEATING Walker Stroller Manual w/c Manufacturer Model Type of control Serial # Color Age Problems with Current Mobility Device Current Seating System Seat Height Seat Width Seat Depth Age of Seating System Sidewalks Rough Terrain Other.
