Problems with my wheelchair:

If my power wheelchair is not working, you can push it by changing it to manual operation. To do this:

• Look for the red dots on the bottom section of the chair at the back. There is a yellow lever beside the dots. Pull the levers up on both sides of the chair. You can now push my chair.

Problems with my communication device

If my device is not working, check that it is turned on. Look for a small red dot at back on the side. Push it.

Please could you check if the wire from my head switch is plugged in my computer in the hole with a yellow dot.

Sample Passport

Introduction and how I communicate

My name is CK.

I have difficulty speaking but I can hear and understand everything you say.

This is how I communicate:

Yes: I look to the right to say “Yes”.

No: I look to my left for “No”.

I want to say something:
I use my voice to call you.

I want to use my display:
I will look over my shoulder. My blue communication display is in my bag on the back of my chair

How I use my display:
Please read how to use my display on the outside of my display.

Things to know when you are communicating with me:

• Talk to me like an adult.
• Read how I communicate. I have a blue book in my bag at the back of my chair. It has instructions on how to use my book.
• Give me time to communicate. Using an AAC system takes more time than speaking.

Please note:

• I make my decisions.
• I need you to keep me informed of everything you are doing.

If you think I need assistance:

Ask me:

• Is this an emergency? If yes, ask me if I need:
• An ambulance?
• Police?

• Call someone?
• Jean, my worker, 222-222-2222
• Sue, my sister, 999-999-9999
• Jim, my brother, 333-333-3333
• My Mom, 777-777-7777

My information:

Name: CK

Wheeltrans registration number: 0000

Tel number: 111-111-1111

In case of emergency, contact:

• Jean, my worker, 222-222-2222
• Sue, my sister, 999-999-9999
• Jim, my brother, 333-333-3333
• My Mom, 777-777-7777