Enter Your Info to Register for an In-Home Trial. Step 1 of 3 33% Client Information. Client's Name*NDIS#My Aged CareYesNoAddress Street Address Address Line 2 Suburb Postcode Client's PhoneClient's MobileClient's Email Therapist Information. Name*AgencyPhoneMobileEmail* Website Client Details. AgeWeightHeightSelf-Transferring? (from what type of equipment)Hoist Required?Equipment Required* Adjustable Bed Transfermaster Lo Lo Healthy Sleep Hi Lo Transfermaster Floorline Equipment Size*Mattress* Pressure Care in Home Pressure Care Water Proof Alternating Air Mattress Size*Lift and Recline Chair* Standard Chair Transfer Chair with removable arm Waterproof fabric Standard Fabric Lift and Recline Chair Size*Request for in-home trial. Date Date Format: MM slash DD slash YYYY Time : HH MM AM PM This iframe contains the logic required to handle Ajax powered Gravity Forms.