Off-the-shelf seating works well for the majority of people who use wheelchairs; however, there are some people who require either customization of off-the-shelf seating or, for those who have more complex needs, custom seating systems. This month, I will discuss some of the modifications that are available in off-the-shelf seating that address skin protection, positioning needs, or personal choice. Some modifications can be done by a therapist in the field. For example, closed cell foam can be carved using an electric carving knife. If done at the factory, many of the customizations involve no additional charge, but to be sure, check the order form. If the customization is not listed on the order form, it does not necessarily mean it is not possible – it may simply mean it is not a frequently requested modification. Checking with the customization department of the manufacturer will give you all the information you need about possibilities and prices.