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Lift Chair Quote
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Email *
First Name *
Last Name *
Address *
Did you need for it to be delivered or you are able to pick up (discount applied for pickup orders). *
If the chair needs to be delivered, please describe where the chair needs to be delivered. Please clarify if there are any steps or narrow passageways.  *
Phone Number *
Which chair are you interested in?
*
Fabric Preference
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