To be completed by Customer
Indicate recommendations for where to lift.
Special Instructions of Precautions:
Brake Release lever location/Free wheel lever location
Note: Your wheelchair must fit through a cargo door for loading: The maximum allowable wheelchair dimensions on Alaska Airlines are 33" high by 42" wide
If your chair is close to the max dimensions:
| Y | N | |
| Does the back rest fold down? | ||
| Can the wheelchair be tipped? | ||
| Are any parts of the chair taken with you into the cabin? |
Items:
| Can the joystick be removed?? |
TZ-616 WHeelchair Information form