Request a Chair Trial

Five Day Chair Trial Request

Name * —Please choose an option—Select your professionOccupational TherapistPhysiotherapist Title/Qualification * Email Address * Contact Phone Number * Name * Place of Work Phone Number Email Address Address —Please choose an option—Select chair modelPulo Mesh Zero Pressure Seat Office ChairTaquile High Back - Standard Seat Office ChairTaquile High Back - Large Seat Office ChairTaquile Extra High Back - Extra Large Seat Office ChairErgo Select Stride High Back - Standard Seat Office ChairErgo Select Stride High Back - Large Seat Office ChairErgo Select Stride High Back - Extra Large Seat Office ChairOther Sizes - Please add details below Requested Chair Model * Other Chair Size Requirements Reason for Trial * Additional Notes or Special Requirements Please prove you are human by selecting the flag.