Comfort Quote Request

Please make sure this is completed correctly. If wrong, the quote will be wrong.

Please tell us what are geographical area you are from.
Example: Glasgow

Name of OT

OT email address.

Initials of client

Have we completed an assessment?

What chair is required?

What depth is required.
Please note that a depth adjustment kit will only be added for 16" and 14".

What posture option is required?

Please select the armrest overhang setting

Please select the handset setting.

Please select the rise setting.

Flat Rise is not available on Small.

Any other notes that should be added to the quote.

(Internal Use Only)

Please upload any attachments that you need logged along with the quote

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