Wheelchair Quantifier

ATConversions > Wheelchair Quantifier

In order to ensure that your wheelchair 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-N. 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^*

User Height^*

Vehicle Info

Vehicle Make^*

Vehicle Model^*

Vehicle Drive Train^*

Vehicle Year^*

Cab Style

Fuel Type^*

Center Console^*

Sunroof^*

Desired Conversion Side^*

Wheelchair Info

Wheelchair Quantifier Example

A - Overall Width (outside to outside)^*

B - Overall Length^*

C - Footrest Width (outside to outside)^*

D - Overall Height^*

E - Sightline to Floor^*

F - Largest Wheel Diameter^*

G - Wheel Axle to Center Steering Wheel^*

H - Footrest Height^*

I - Knee Height^*

J - Footrest Offset^*

K - Front Tire Width (outside to outside)^*

L - Chest to Steering Wheel^*

M - Top of Legs to Sightline^*

N - Back to Front of Toes^*

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.