The Permobil Foundation is the philanthropic arm of Permobil and offers assistance for end-users who are denied funding by their insurance for a chair or chair part that is medically necessary for their independence. The Permobil Foundation Board of Directors meet once a month to review all requests. Applications are due by the 20th of each month, no exceptions.
Applications must be fully completed along with the uploaded required documents including insurance denial.
In order to complete this application you will need the wheelchair dealer/vendor contact information and Permobil quote #
The submission of this application shall serve as proof that all information is complete and truthful. Further, the applicant certifies that all options to obtain coverage and payment from insurance(s) have been attempted and exhausted. Any incomplete applications will be rejected.