Call Us: 1300 726 666 - Mail: info@medirent.com.au

Order Form

Please fill out all details below. Your order request will be reviewed by our customer service team who will call you to confirm your booking and take your payment details.

PLEASE NOTE: Filling out this form does not guarantee your order until we have called you for payment.

Name*

Email*

Phone *

Address *

Products *
OsteotronLX9DVT-2600Rebound RecoveryKinetec KoolerCryotecCPM - ShoulderCPM - ElbowCPM - KneeCPM - AnkleAmeda Platinum Breast PumpAmeda Elite - Breast PumpMedela Symphony Breast PumpBreast pump kitBassinet

Dates required
From To

Delivery or pick-up from our warehouse (Delivery may incur an additional fee)
deliverypick-up

Physician name if applicable

Any extra information

Please enter the code shown into the box*
captcha

Medi-Rent Pty Ltd

Unit 3, 61 Beauchamp Rd
MATRAVILLE NSW 2036

NATION-WIDE DELIVERY

P: 1300 726 666
I: 02 9700 1744
F: 02 9316 9998

info@medirent.com.au
www.medirent.com.au

Business Hours

Weekdays: 9am to 5pm

After-hours

For after-hours emergencies with your equipment please call 1300 726 666 and leave a message. We will call you back as soon as possible.

Social Network

Back to Top