Complete the form below to request an equipment trial. A product specialist will contact you to discuss and to confirm your requested date and time. Please ensure you have completed and attached a Rehab Referral Assessment Form. The form can be downloaded from the REFERRAL FORMS pull down menu.
Monday to Friday: 8.30am – 5.00pm | Saturday and Sunday: Closed | Public Holidays: Closed
Please upload your completed Rehab Referral Assessment Form by clicking the button below.