TSS Trial Form - Murrays Medical

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FREE Safety Sleeper Home Trial Application

For families interested in trialing the Safety Sleeper, we have a FREE home loan programme. We will provide a Safety Sleeper for one week to allow you confirm that it is suitable before you proceed to secure funding.

Nameyour full name

Emaila valid email

Address 1

Address 2

Post Code

Telephone Number

Model Differences:

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Which Safety Sleeper are you interested in trialing?

StandardProfessional

Please tell us the name & age of the child as well as their medical needs, specific to benefiting from the Safety Sleeper

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Please confirm the most likely source of funding for the Safety Sleeper?We can provide a list of helpful charities that assist families, if required

Self-fundingLoanSocial Services/OT/PhysioCharityCombination - e.g. Social Services/OT/Physio + Self, Social Services/OT/Physio + Charity etcOther