Midland Wheelchair Hire

Birmingham Area Wheelchair Hire - Delivery and Collection Included

Call Midland Wheelchair Hire...10:00am - 15:00 ... Carrycall

Including postcodes B46, B77, B78, B79

Covering Coleshill, Water Orton

and including Wolverhampton

Title

First Name

Last Name

Contact No.

Address

Town/City

Postcode

User

Wheel Type

Wheelchair Type

Delivery Date

Hire Period

Elevating Leg Rest

Message

Subtotal

Payable