Distribution Reports

Once you have completed your distribution, you will need to fill out and complete the Distribution Report.


All future shipments are determined by the timeliness and quality of your reporting. Late or poor reporting could lead to a decrease in shipment and shipment frequency.

Per the Distribution Agreement, we require that you complete the following FWM Wheelchair Container Report.

  • It is entirely online through this link: https://www.surveymonkey.com/r/WHEELCHAIR_CONTAINER_REPORT
  • You must complete the report in one sitting (this allows you to use this same link for each report that you do)
  • To make sure you have all the information you need before clicking the link to complete the report, you can use the PDF version to reference and manually fill out ahead of time.
  • The online report includes the photos (before and after) & story to be uploaded at the end, so please have:
    • Client Story saved as word document
    • Before Photo and After Photo each saved as a jpeg, png, or jpg
  • If you cannot finish distributing all the wheelchairs for this container by the due date, let us know so we can adjust your due date. You cannot request an extension after the due date.

If you need assistance or you have any questions about completing the report, please contact Tess Stansbury at tstansbury@freewheelchairmission.org