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Wheelchair Repair Request
The Wheelchair Repair Shop: 403 SE 80th Ave, Portland, OR 97215
Email
example@example.com
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Zip Code
This is a...
Power Wheelchair
Manual Wheelchair - rigid frame
Manual Wheelchair - folding frame
I'm not sure
Other
In 2-4 sentences can you tell us a little bit more about what you need? Please include any details that might help our mechanics. For example, the make and model of your wheelchair, the tire size, what specific parts need attention, etc.
Would you like to OPT-IN to reminders and maintenance tips?
I'd like to receive EMAILS.
I'd like to receive TEXT messages.
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