Hand-powered Tricycle – RE 005

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Shower Chair – BA 008

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Shower chair – BA 019

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Bedside Commode – BA 018

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Walker stablizer with hand grips and seat – WA 005 (brake system to prevent falls)

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Leg Walker – WA 004

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Pediatric Stnader – ST 003

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Gazelle Pediatric snug Seat – ST 002

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Pediatric Stander – ST 001

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.

Electric Wheelchair – WH 006

(needs battery – Dual U1 or 22 NF - but Friends of BCFR could provide assistance in purchasing one. Seat is 18-by-16 inches and has a 250 lb.capacity.)

TO REQUEST this item, download and complete the Assistive Tech Exchange Program Referral in full, including all required signatures. A medical professional such as, but not limited to, a physician, physician assistant, occupational and physical therapist, nurse, medical case manager or social worker MUST sign the referral form. 

Individuals cannot receive any piece of equipment without the consent of one of the medical professionals listed above.

Once the request form has been filled out and signed, contact Sara Agnew, Outreach & Referral Coordinator, to set up a time to retrieve the item. The Assistive Tech Exchange Program Referral must be filled out in full at the time of pick-up.

Sara Agnew can be reached by e-mail at sagnew@bcfr.org or call her at (573) 874-1995, ext 160.