Request a FREE Demonstration of the Storm4

Please fill in your details below and click send we will get back to you as soon as possible. (* required information)

Name*

E-mail address*
Phone*
Is this phone number for Home, Work or a Mobile?

Full Address*

UK Postcode*


Please include 'must have' requirements and disability details:

Help us to help you

Fill in the following 2 questions to be entered into a monthly prize draw to win £50*

Where did you hear about us?
From a friend or relative
Google search
I'm an existing customer
A magazine (see below)

Please specify name of magazine

If none of the above, how you did hear of us?

If you read any disability magazines which ones?


* Draw will take place on the 1st of each month for the previous
month and winners will be notified by the contact details supplied
in this form.

One of our wheelchair specialists will contact you to discuss your requirements and to book a date and time for your
FREE Demonstration.