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Habibi Wheelchair Booking Form
We will contact you shortly. Alternatively, you may contact us on our Hotline: (+65) 8828-1538. You can CALL, SMS OR WHATSAPP whichever floats your boat.
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Name
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Wheelchair Type
*
Habibi Mini (Assisted)
Habibi Lightweight (Self-Wheel)
Habibi Prime (Self-Wheel)
Start of rental
*
MM
/
DD
/
YYYY
End of rental
*
MM
/
DD
/
YYYY
Address
*
Your answer
Type of Usage (Refundable Deposit)
*
Choose
Local Use ($100)
Overseas Use ($150)
Other thoughts or comments
Your answer
By providing your personal information to Habibi Wheelchair LLP, you consent to the collection, use, and disclosure of your data in accordance with the Personal Data Protection Act (PDPA).
We will use your personal information to:
1. Process your rental requests and deliver our services.
2. Communicate with you regarding your bookings, queries, or updates on our services.
3. Provide relevant updates or promotional offers (if you have opted in).
We respect your privacy and are committed to safeguarding your information. Your data will only be shared with third parties as necessary to fulfill the services you’ve requested or as required by law.
For further details, please refer to our
Privacy Policy
.
If you have any questions or wish to withdraw your consent at any time, please contact us at +65 8828 1538 or +65 8181 1004
*
I consent to the collection, use, and disclosure of my personal data as described above.
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