National Seating & Mobility Survey
Calling all wheelchair users – ENOUGH IS ENOUGH! Do you believe the mobility equipment giant National Seating & Mobility, with its 117 locations, is getting too BIG? Are you hearing stories of how National Seating & Mobility is cutting corners resulting in harmful experiences to our community members? Have you experienced an unfortunate wheelchair repair and/or equipment purchase? If so, share your story with The Spinal Cord Injury Law Firm through this form TODAY to help not only yourself but also others in our community! National Seating & Mobility can and will change its practices if we speak up together. This form is HIPAA compliant.
Full Name
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First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
State you live in
*
Please Select
AK
AR
AZ
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
Please check all boxes relating to problems that you have faced with National Seating & Mobility.
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Delay in Receiving Parts or Service
Received Defective or Wrong Part
Cushion Issue
Footplate Issue
Untrained Technician
Wheel Issue
Head Array, Sip and Puff, or Chin Control Issue
Software Problem
Joystick Placement
Wheelchair Frame Issue
Improper Loaner
Other Service Issue
Improper Billing
Provided Refurbished Parts without my Consent
Service unable to be performed onsite with customer, ie, took mobility device away from customer
Other
Please check all boxes relating to how you've been harmed.
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Damaged Wheelchair
Damage to Home
Injury to the Body
Pressure Wound / Skin Damage
Hospitalization / Further Medical Treatment
Homebound / Bed-bound
Monetary
Fraud
Emotional Distress
Loss of Limb
Death
Other
Share your National Seating & Mobility Problem / Story
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Do you need immediate help?
1
2
3
4
5
When did the problems and harms occur?
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Ex: You can provide an exact date such as September 5, 2019, or you can be more generalized with the following: September 2019, all throughout 2019, or you can answer ever since I started working with National Seating & Mobility in 2017
Do you have any support documents?
Browse Files
Drag and drop files here
Choose a file
Ex: You can provide pictures of your wheelchair, wounds, billing documents, or any documentation surrounding the problem or harm to you.
Cancel
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Would you be willing to be contacted by The Spinal Cord Injury Law Firm to help advocate on your behalf to hold National Seating & Mobility accountable? There are no costs to you for this free consultation.
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Yes
No
Can a Spinal Cord Injury Firm team member contact you to discuss possibly sharing your story and to collaborate with you to help others in the community facing similar problems with National Seating & Mobility?
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Yes
No
Submit
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