The documents below are required for continuing the iBOT® journey. Please feel free to call us at 1-833-346-4268.
Form Name (Click to access) | Responsible Party | Action to Take |
Customer Intake Form | Prospective iBOT® User OR Authorized Representative | Fill in and Sign. |
iBOT® Customer Handbook | Prospective iBOT® User OR Authorized Representative | Review. |
iBOT® Prescription Template | Medical Professional – Doctor | Bring to your physician for completion and signature. |
iBOT® Patient Assessment Form | Medical Professional – MD, PT, or OT | Bring to your physician or therapist for completion and signature. |
iBOT® Assistant Assessment Form | Assistant(s) | Optional. To be reviewed with any assistant(s) prior to assisted stair climbing. |
Please email all forms to our secure inbox at clinical@mobiusmobility.com OR fax them to 603-621-0789.