Power Chair Quantifier

ATConversions > Power Chair Quantifier

In order to ensure that your power chair will sufficiently fit in your converted vehicle, we need for you to fill out the following quantifier form. We know there are a lot of questions, but they are all important in determining a correct fit. Use the example graphics below for items marked A-V. You’ll also need to attach a picture of the person in their power chair at the end of the form.

If you’d like to download the worksheet to print out, click here.

* = Required Fields

Your Info

Name^*

Phone^*

Email^*

Dealer Name (If Applicable)

Salesperson You Are Working With (If Applicable)

User Weight^*

Vehicle Info

Vehicle Make^*

Vehicle Model^*

Vehicle Drive Train^*

Vehicle Year^*

Desired Conversion Side^*

Cab Style

Fuel Type^*

Sunroof^*

Power Chair Info

Chair Brand^*

Chair Model^*

Chair Weight^*

A - Mid Tire Width^*

B - Rear Tire Width^*

C - Overall Length / Tip of Toes^*

D - Footrest Width^*

E - Armrest Width^*

F - Overall Width^*

G - Overall User Height^*

H - Sightline to Floor^*

I - Center Wheel to Back Wheel^*

J - Center Wheel to Front Wheel^*

K - Wheel to Steering Wheel^*

L - Floor to Footrest^*

M - Floor to Bottom of Armrest^*

N - Floor to Top of Legs^*

O - Floor to Top of Armrest^*

P - Diameter Rear Wheels^*

Q - Diameter Mid Wheels^*

R - Diameter Front Wheels^*

S - Width of Front Tires (outside to outside)^*

T - Chest to Steering Wheel^*

U - Top of Legs to Sightline^*

V - Furthermost Back to Front of Chair^*

Additional Comments

If there are any irregularities with your setup, please list them here.

Photo of customer in the power chair that will be used with conversion. (Max file size: 10MB)^*

This guide is to be used to determine if the client fits in the vehicle with the chair submitted. It is not to be used to determine if the driving position will be satisfactory to the client. ATC shall not be held liable for driving position issues.