Hire Enquiry

First name*

Last name*

Email*

Phone number*

Describe Your Role* Patient/CarerOccupational Therapist/PhysiotherapistPlan Manager/Support CoordinatorHospital WorkerNursing / Group Home EmployeeArchitectSchools & Education

Delivery Address*

Suburb*

State/ Territory*

Unfortunately we don't hire equipment outside of NSW.

NSW

Postcode*

NSW only.

Funding Type* Cash SaleNDIS Self ManagedNDIS Plan ManagedNDIS Agency ManagedEnableAged Care Package

What product(s) would you like to hire?*
Basic Power WheelchairPower WheelchairManual WheelchairMobility ScooterWalkerKnee WalkerPatient Lifting Hoist with Standard Spreader BarPatient Lifting Hoist with Pivot FrameCeiling HoistGantry SystemRampsShower CommodesOther - Specify in Box below

Additional Comments/Requests

From*

Hire To Date*

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