Walker Order Form

Thank you for visiting our walker/rollator order form.  Please be sure to enter a shipping address if your mailing address is a P.O. Box and complete the form entirely before submitting.   Our Walker/ Rollator are shipped at no cost to you within the continental U.S. Most orders placed before 2:00 P.M. , EST will ship the same day. Please allow 7 to 10 business days for delivery after placing your order ( However, most orders will arrive within 6 business days.). Overnight, second day or third day shipping is available to most address's at an additional fee. We do have a 30 day return policy. If you are unhappy with the item you have purchased, for any reason, you may return it within 30 days for a refund of the purchase price, less a 20% restocking fee and all shipping fees. For details, please see our RETURN POLICY. If you have any questions before or after placing your order, please feel free to contact us as listed below:

Toll Free

1-800-449-8991

Phone

727-549-0604

Fax

727-549-0614

E-mail

sales@americanwheelchairs.com

 

Please enter your name as it appears on your credit card.

First name:    Middle: Last name:   

Please give us your mailing/billing address: (same address your credit card statements are mailed to)

Address 1:   

Address2:   

City:   

State:      ZIP/Postal code:

Phone Number:   NOTE: Contact Telephone Number is Required

If your shipping address is different from your mailing address, please list it below (NOTE Shipping Address cannot be a PO Box! We must have a physical Address!!):

First name:    Middle: Last name:   

Address 1:   

Address2:   

City:   

State:      ZIP/Postal code:

E-mail address:   

Phone number:      NOTE: Contact Telephone Number is Required

Optional Information

Fax number:   

Cell Phone:     

Please select the walker(s)/rollator(s) that you would like to order:

 Three Wheel Rolling Walkers

3 Wheel Rolling Walker Model: W320- $99.95      Color:     

Accessories:  Oxygen Holder Bag - $28.95

3 Wheel Rolling Walker Model: Rally 717- $139.95      Color:     

Accessories:  Oxygen Holder Bag - $28.95

3 Wheel Rolling Walker Model: 729 Lite - $140.95       Color:     

Accessories:  Oxygen Holder Bag - $28.95

3 Wheel Rolling Walker Model: Traveler  - $144.95   Color: 

Accessories:  Oxygen Holder Bag - $28.95

Four Wheel Rolling Walkers

4 Wheel Rolling Walker Model: Royal 807 - $169.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95

4 Wheel Rolling Walker Model: Royal Petite 809 - $199.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95

4 Wheel Rolling Walker Model: Royal DLX - $239.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95

4 Wheel Rolling Walker Model: Cruiser Deluxe Jr. - $207.00    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Rubber Seat Pad - $26.95

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

4 Wheel Rolling Walker Model: Cruiser  - $158.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

4 Wheel Rolling Walker Model: Cruiser II  - $143.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

 

Heavy Duty Four Wheel Rolling Walkers

4 Wheel Heavy Duty Rolling Walker Model: Mack  - $239.00    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

4 Wheel Heavy Duty Rolling Walker Model: Discovery  - $272.95    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

4 Wheel Heavy Duty Rolling Walker Model: Regal  - $369.00    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

4 Wheel Heavy Duty Rolling Walker Model: WOK 750  - $599.00    Color: 

Accessories:  Oxygen Holder Bag - $28.95   

                     Travel Bag - $49.95

                     Hanging Walker Bag - $28.95

 

Adjustable Folding Aluminum Walkers

Aluminum Walker Model 4060 - $62.95

Aluminum Walker Model 4070 - $67.95 

Aluminum Walker Model 4070D - $67.95

Aluminum Walker Model 4070Y - $67.95

Aluminum Walker Model 4070DW3 - $84.95

Aluminum Walker Model 4070YW3 - $84.95

Aluminum Walker Model 4070DW5 - $97.95

Aluminum Walker Model 4070YW5 - $97.95

Aluminum Walker Model 4090D - $67.95

Aluminum Walker Model 4090Y - $67.95

Aluminum Walker Model 4090DW3 - $85.95

Aluminum Walker Model 4090YW3 - $85.95

Aluminum Walker Model 4090DW5 - $99.95

Aluminum Walker Model 4090YW5 - $99.95

 

 

Select the credit card you would like to use:

       Master Card

       Visa

       Discover

       American Express

Please enter your credit card number

Please enter the 3 or 4 digit security code on your credit card:

Please enter the expiration date on the credit card.

Additional questions, comments:

By clicking the "Submit" button below, you agree that you have read and accept our return policy.

Thank You!