Accessibility Survey | Wheelchairescapes

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Accessibility Survey

Wheelchair Escapes takes great pride in creating an enjoyable, memorable travel experience for all of our clients!

What's important to you?

Take a moment and tell us what's important to you when it comes to travel.

This is a Lacroix Experience Survey.

When you travel, please indicate what you would like to expect or/need during your stay.

For your bedroom:

Wide doors, Automatic entry door, Adjustable bed height

1 bed, 2 beds, Hospital bed

Hoyer lift, Grab bar above the bed, Trapeze

Emergency cord, 5 foot turnaround, Connecting rooms

Tight weave carpet or no carpet

For your bathroom:

Roll in shower, Attached shower seat with arms

Attached shower seat without arms, Separate shower seat, Grab bars in shower

Adjustable shower head height, High liner toilet, Commode seat raiser

Grab bar to the right of the toilet, Grab bar to the left of the toilet, Low toilet

Sink open under counter

For the restaurant or dining:

Correct height table with extensions, Specific tables for wheelchairs on aisles

Wide walkways between tables, Turn around space

Buffet table at correct height

Other

Other requirements you would require to allow your stay to be comfortable:

TTY on phone, Speak the floor level in the elevator, Braille

Flashing light for emergency, Hire a care assistant, Accessible van rental

Other

What type of fun activities would you be interested in experiencing?

Where are the top destinations that you would like to vacation:

Your Name

Phone

Thanks for submitting!

Kristy Lacroix - ACC, MCC, ECC, CTA

Your personal travel advisor

An Independent Agent of Cruise Planners

Toll Free: 866 382 3596

Phone: 603 382 3596

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