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* 1. Was the NHS Voucher Scheme available where you live? If so where? What postcode?

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* 2. When did you First Apply to get a Wheelchair Voucher from the Wheelchair Service?When did you get the Voucher?

Date
Time
Date
Time

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* 3. How long has it taken you on Renewal Application to get a Wheelchair Voucher from the Wheelchair Service?

Date
Time

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* 4. How much was your Wheelchair Voucher?

0 2000
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i We adjusted the number you entered based on the slider’s scale.

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* 5. Which Wheelchair Service did you use?

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* 6. How easy?

1 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 7. Did you get an adequate Wheelchair for your needs?

1 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 8. Was the Full Cost of the Wheelchair met by the Voucher?

1 100
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 9. How long until you got the Wheelchair?

Date
Time

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* 10. How much extra did you end up paying for it, if at all? Any additional comments..

T