| You need to tell us your name |
| You need to tell us your postcodeFind your postcode on royalmail.com. |
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| You need to tell us your phone number |
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| What type of mobility scooter do you have?Missing or incorrect value |
| Are you able to leave your home without the use of a mobility scooter? |
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| Are you on a waiting list to use the storage at the facility? |
| Do you use the storage provided at the facility? |
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| Do you have insurance for the mobility scooter? (We may ask for a copy of your insurance document) |
| Is your scooter serviced regularly? |
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