Patient is very involved medically (i.e. severe postural deformities, pressure sores, on a ventilator, progressive disorder, etc.).

Reccommendation: Evaluation* and documentation be in collaboration with a certified assistive technology professional at the nearest health system or hospital-based outpatient facility or clinic (search here) who can advise on considerations of insurance stipulations, assistive technologies, wheelchair selection, vendor selection, wheelchair fitting, and seating evaluation.

Note
*Some insurance will require an evaluation by a licensed PT or OT. Some therapists may be comfortable performing these evaluations but others may not and can help with referring to a qualified therapist to do a thorough evaluation.