Medical Providers, Social Workers, and Ministerial Staff Members,
EmmanuWheel is a nonprofit organization providing wheelchair ramps to those with significant mobility impairment who cannot afford the cost of the ramps. Because of the tremendous need in our community and EmmanuWheel's limited resources, your help in establishing eligibility is invaluable.
Please download the EmmanuWheel Client Referral Document on this page, complete all information on the form, and submit the form to our intake coordinator email or US Mail. It is important that ALL information on the Client Referral Form be complete prior to sending the form to us.