Book a Trial

Disclaimer: Please note this online appointment booking tool is for trials which you have approval for only and is subject to confirmation with our customer care team. 

Privacy policy: Your privacy is important to us at Euromedical Ltd. This data is treated confidentially and will not be shared other than to an authorized Euromedical representative to service your enquiry.

"*" indicates required fields

Your name:*

First Last

I am a:*

Please choose from the below optionsOccupational TherapistPhysiotherapistClinical AdvisorProcurement managerHealth Facility managerHealth service technicianTherapy assistantAdministration receptionistParent or caregiverCharity providerStudentEnd userOther

Email:*

Phone:*

Company:

Client Name*

First Last

Address of appointment:*

Street Address Address Line 2 City ZIP / Postal Code

Brief description of outcome needed at appointment:*

Seated Measurements

With any seating equipment, these measurements allow us to make sure everything is correct.

A Hip Width:

B Thigh length:

C Shoulder height:

D Chest width:

 

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Standing Measurements

With any standing equipment, these measurements allow us to make sure everything is correct.

G Chest circumference:

H Inner leg length:

I Floor to axila height:

 

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Seated Measurements cont...

E Axila height:

F Lower leg length:

 

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Standing Measurements cont...

J Foot to head:

F Foot to patella:

 

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Client weight (kg):

Preferred appointment date and time:

Date:*

If your selected date/time isn't available a member from our customer care team will be in touch to confirm a different time.

DD slash MM slash YYYY

Time:*

Hours

:

Minutes

AM PM AM/PM

Any further details or comments:

Tell us how we can make this appointment amazing! Also, is there any useful information such as finding the right property at the address given?

Trial Approval Number:*

Attach Trial Approval:*

Max. file size: 30 MB.

Consent*

Your privacy is important to us at Euromedical Ltd. This data is treated confidentially and will not be shared other than to an authorized Euromedical representative to service your enquiry.

I agree to the above privacy policy.