Start Assessment

Tell us what support is needed.

Answer a few simple questions about the person, their daily needs and where the equipment will be used. You do not need to know the exact product.

Not sure about an answer? Choose ?Not sure? where available. SafetyAid will review the information before suggesting the next step.

This form supports equipment guidance. It is not a medical diagnosis or emergency service.

Where will the equipment be used?

Choose where the equipment will be delivered and used. Pakistan Support is only for delivery in Pakistan. International & Export is only for delivery outside Pakistan. A person in Pakistan may submit on behalf of an overseas equipment user.

Support route

PakistanOutside PakistanNot sure yet

Delivery country

Who needs support?

کس فرد کے لیے مدد درکار ہے؟

Who needs support?

Child Adult Age group not known

Diagnosis or condition, if known A diagnosis is not required. Describe the person’s functional needs even if no diagnosis has been confirmed.

What help is needed?

سب سے اہم مسئلہ کیا ہے؟

Functional support areas

Select all that apply. You can also choose Not sure.

Highest-priority need

Tell us a little more

آپ کے منتخب مسئلے کے مطابق متعلقہ سوالات یہاں ظاہر ہوں گے۔

Select the main difficulty above. Relevant guidance questions will appear here.

Fall risk / balance

Has the person fallen before? Where is the risk highest? Does the person use support now? Can the person stand safely without help?

Sitting posture / trunk support

Can the person sit independently? Does the body lean? Head support needed? Side/trunk support needed? Is a tray needed for feeding, study, or arm support? Main use

Standing / walking support

Can the person bear weight on legs? Can the person take steps? Main goal Current device used

Bathroom safety

Main bathroom difficulty Bathroom type Is wall support possible? Can bathroom photos be sent on WhatsApp?

Transfer and caregiver support

Most difficult transfer How many caregivers assist? Is lifting becoming difficult or unsafe? Does the transfer require significant physical assistance?

Not sure what fits?

Tell us what you are noticing

Current equipment and daily routine

Share only simple starting details. If SafetyAid & Co. asks for body or space measurements later, please write them in centimeters (cm).

صرف ابتدائی معلومات دیں۔ ضرورت پڑنے پر ری ہیب مارٹ بعد میں درست پیمائش مانگ سکتا ہے۔

Age Approximate weight Current equipment Help currently provided Help provided by a person, caregiver, rail, furniture, or environmental support. Extra note

Daily environment and routine

Share what is relevant to the places, activities, access, and support involved in daily use. These fields are optional.

Main place of use Indoor or outdoor use Caregiver availability Floor level, stairs, or lift access Doorway or room-space limitations Bedroom access Bathroom access Daily routine or activity priorities Vehicle or transport considerations

Professional input, if available

You can complete this form without a professional. If a therapist, doctor, clinic, school or hospital is involved, you may add their relevant observations or precautions.

Is a professional or institution involved?

NoYesNot sure

Professional or institution type Professional or institution name Relevant observations Important precautions Existing recommendations

Measurements and photos, if available

Photos or short videos can be sent through WhatsApp after submitting this form.

Photos, videos and measurements can support review but do not guarantee suitability, sizing or a final recommendation. Do not record unsafe movements. Information sent through WhatsApp is also subject to WhatsApp’s privacy and retention practices.

ضرورت ہو تو واٹس ایپ پر محفوظ اور باوقار تصاویر یا ویڈیوز بھیجی جا سکتی ہیں۔

Person sitting from front and side
Walking or standing video if safe
Bathroom/toilet area photo for home safety
Existing chair/walker/device photo
Transfer area photo if transfer is difficult

Send only safe and dignified photos or videos. Do not record unsafe movements just for the form.

Exact body measurements or space measurements may be requested later depending on the support need. Please write measurements in centimeters (cm).

Photo/video privacy

Photos and videos shared for assessment are used only to understand the support need and guide product selection. SafetyAid & Co. does not post, publish, advertise, or share personal photos/videos publicly without clear permission. Please send only safe, dignified, and necessary photos or videos.

تشخیص کے لیے بھیجی گئی تصاویر یا ویڈیوز صرف ضرورت سمجھنے اور مناسب رہنمائی کے لیے استعمال کی جاتی ہیں۔ ری ہیب مارٹ آپ کی اجازت کے بغیر ذاتی تصاویر یا ویڈیوز عوامی طور پر شائع، شیئر یا اشتہار میں استعمال نہیں کرے گا۔

Need help with measurements?

Exact measurements are not required at the first step. If SafetyAid & Co. asks for measurements, these guides can help you prepare.

Measurements available

Not availableSome measurements availableProfessionally measuredNot sure

Seating measurements Mobility / walker measurements Bathroom measurements Transfer measurements Home safety measurements

Your contact details

رابطے کے لیے اپنا نام، شہر اور واٹس ایپ نمبر درج کریں۔

Your name Your city Your country Phone or WhatsApp number Email address Your relationship to the person needing support Please describe the relationship

Preferred contact method

WhatsAppPhoneEmail

Review and contact SafetyAid

Review the details below. Use an edit button to return to a section without losing entered information.

معلومات چیک کریں، پھر واٹس ایپ پر بھیجیں۔

Your details will appear here when you choose Review Details.

Review the details below. You can copy them, open WhatsApp and paste them when you are ready. SafetyAid will only receive the information you choose to send.

Information shared through WhatsApp is subject to WhatsApp's privacy and retention practices.

Open WhatsApp

رہنمائی کے لیے واٹس ایپ پر اپنی ضرورت، تصویر یا ویڈیو بھیجیں۔

Your photos/videos are reviewed for assessment guidance only and are not used publicly without permission.

آپ کی تصاویر یا ویڈیوز صرف رہنمائی کے لیے دیکھی جاتی ہیں، اجازت کے بغیر عوامی طور پر استعمال نہیں کی جاتیں۔

This assessment supports assistive equipment guidance only. SafetyAid & Co. does not provide emergency services, diagnosis, or medical treatment through this form.