Matia Mobility Site Visit Certification

Site Visit Form

Client Information


THIS REPORT WILL READ: 

Please let this certify that based on an inspection of the home of the insured that the home is designed in such a manner that the individual can utilize the Tek RMD M1 standing mobility device to navigate door openings, transitions, and surfaces to move freely between bedrooms, bathrooms, kitchen, and other living areas of the home.

Specifically noted is that a standing mobility platform like the Tek RMD M1 is required to allow the user to reach counter tops, upper cabinets, cooking surfaces, and other standard height fixtures in the home.

A lesser device, including powered or non powered wheelchairs, standing frames, and other traditional devices will not allow the individual to function independently in the activities of daily living.

Based upon this evaluation, the Matia Mobility Tek RMD M1 is medically necessary.