In-service and Product education request

In-service and Product Education Request

Experience the Active Mobility Premium Service
Name*

First NameLast Name
Organisation*
Mobile Number*
Please enter a valid phone number.
Email
example@example.com
Who would you like to conduct this training

AMS Product specialistAMS Occupational therapist
Best days to deliver the education session*
What would you like to learn more about?*

Manual handlingMAT Evaluation (express 3 hours)Prescribing equipment (complex AT)Prescribing equipment (Basic AT)Power add-on vs power wheelchairPressure CareSeating measurement and Seating adjustmentBasic Wheelchair adjustmentBariatricsScooter prescriptionHospital Discharge solutionsCommode ConsiderationsBedsLift Chairs/ReclinersRobotic ArmsShower TrolleyOther
Beds

Pressure ReliefBed's MechanicSleep PositionAccessoriesOther
Prescribing equipment (complex AT)

Power Wheelchair PrescriptionManual Wheelchair PrescriptionSeating PrescriptionAlternate Control PrescriptionOther
Manual Handling - hoists and Fall prevention

Ceiling HoistsSlingsFloor hoistsOther
Off the shelf solutions

Manual wheelchairsPower wheelchairsWalkersBathroom aidsOther
Please specify
Please provide more information on the topics/products you would like to learn more about
What are you looking to achieve out of this course?
Preferred location of the session

Your OfficeActive Mobility's training room - SilverwaterActive Mobility's training room - NewcastleElsewhere
Please provide the address for this session

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this session going to be for*

MeNew staff member/sGroup/Refresher training
Attendee/s details*
How many staff members will be attending this session?
Notes and comments
Upload any relevant files or photos

upload files, reports, pictures, videos, spreadsheets, or any other related information.
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