Donate Equipment | Wheels to Heal

Desired Uplift Date: *

If the dates above are not suitable please contact us on uplift@wheelstoheal.org.uk and we will try to accommodate you. However we can not guarantee an uplift as we are a volunteer-driven charity.

Name of Care Home/Organisation/Person: *

Address: *

Contact Name: *

Contact Telephone Number: *

Contact Email Address: *

Number of Manual Wheelchairs:

Number of Electric Wheelchairs/Scooters:

Number of Three-Wheel Rollators:

Number of Four-Wheel Rollators:

Number of Zimmer Frames:

Number of Crutches:

Number of Walking Sticks:

Number of Mobile/Static Commodes:

Number of Table Trolleys:

Number of Adjustable Stools:

Number of Shower Chairs:

Number of Shower Supports:

Number of Medical Beds:

Number of Over-the-Bed Tables:

Number of Wipeable Mattresses:

Number of Hoists:

Number of Other Equipment Items:

E.g. blankets, bed supports, etc. Please enter descriptions and quantities.

Equipment Location:

E.g. reception, storage cupboard, shed, outside, etc.

Declaration *

These mobility aids do not belong to any other organisation/individual and I have authorisation to donate them to Wheels to Heal.

Message