Logo for: Lifeway Mobility Chicagoland (847) 215-9490

Give and receive! Recommend Lifeway to a friend and you'll both get a $50 gift card.

There is no better compliment than when a customer refers us and we want to show our appreciation. With Lifeway Mobility’s friends and family offer, both you and your friend can receive a $50 gift card when you refer us a new customer.

Please fill out the form below with both your contact information and your friend’s. If your friend becomes a customer* we will send you both a $50 gift card to thank you for choosing Lifeway.

* Applies to purchase of stairlifts, installed modular ramps, accessible shower/bath systems, and lifts/elevators. Must be eligible to participate. Certain professionals such as clinicians or government employees may still make a referral but are not eligible for gift cards or other compensation from Lifeway Mobility. Purchases involving governmental funding are not eligible for this program.

Who is Referring the New Customer?

Referrer's First Name*

Referrer's Last Name*

Company Name*

Referrer's State*

Referrer's Phone Number*

Referrer's Email*

Are you a Clinician*

Are you a Government Employee*

New Customer Information

Referral's First Name*

Referral's Last Name*

Referral's Email

Referral's Phone

Referral's Address (of installation)

Referral's City (of installation)

Referral's State*

Referral's Postal Code