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Homecare Bed Rental - Rakusho Z Series
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Rakusho Z Series Homecare Bed
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Type of Mattress (Please Choose One)
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Rakusho Z Bed + Stretch GlideMattress $320 / month
Rakusho Z Bed + Cococia FukaAir Mattress $400 / month
Requested Delivery Date (exclude weekends and public holidays) *subject to availability*
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MM
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Requested Delivery Time
AM (9-12nn)
PM (2-5pm)
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Full Name (NRIC) of Renter
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Mobile Number
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Delivery Address
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Name of Home Recipient (if differs from Renter)
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Mobile No of Home Recipient
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Rental Duration
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1 Month
3 Months
6 Months
Level Of Stairs
If required to carry goods on stairs, please advise ($95 each flight for Standard delivery & $65 for express delivery)
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None
1 flight of stairs
2 flight of stairs
3 flight of stairs
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Other:
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