Tubway Bathtub Modification

Name*

Address*

Phone Number*

DVA Number (If applicable)

Bathtub Type*

Acrylic fibreglass
Pressed metal
Cast iron

Bathtub Shape

Standard Rectangular
Square hip bath

General condition of the bathtub

Is there a toilet fitted in the bathroom*

Yes
No

Is there a glass screen/ door fitted on the bathtub*

Yes
No

Is the bathroom situated on the ground floor*

Yes
No

Has the bathtub or tiles surround been resurfaced / Reglazed in the past*

Yes
No

Are the taps in /above the bathtub in good order ( Leaking tap must be repaired before Tubway technician arrival )*

Yes
No

Is there an open window access to outside the bathroom*

Yes
No

If window has fly screen, please inform if window's fly screen can be removed*

Yes
No
n/a

Is there electrical power point in the bathroom*

Yes
No

Area of the bathroom*

Small
Medium
Large

Please provide pictures of the bathtub and bathroom. Please email to [email protected]*

Pictures of bathtub sent
Pictures of bathroom sent

Is the request been coordinated with an Occupational Therapist*

Yes
No

Standard Tubway width is 450mm unless requested otherwise. Please advise if you have other requirements

Typically Tubway access is completed at the side of the tap / shower wall, that will allow the person to face the taps when taking a shower. Please advise if you have other requirements.*

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Tubway Bathtub Modification