TENS hire form

TENS Hire Form

My Birth Geelong
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Email*
Phone number*
What is your estimated due date?*
Preferred hire commencement/ pick up date (from 37 weeks)*
How would you like to receive your TENS?*
Would you like to add a colostrum expressing kit to this order?*
Medium Kit- 8 syringes Large kit- 16 syringes
How did you find out about TENS hire through My Birth Geelong?
If you have any questions, please let me know
TENS hire fee is $90 for a (up to) 5 week period commencing from 37 weeks. You can opt for collection from Highton, or express postage (postage fee applies).

**If the hire starts after 37 weeks, the hire fee remains the same as the price is not based on length of time the machine is hired out.

TENS pick up is from a collection box in Highton- address will be supplied once booking is made.

Everything in the TENS bag is to be returned, minus the sticky electrode pads, batteries (single use only) and the fridge magnet- this is yours to keep. Return of the TENS can be via drop off to the same box, or postage back.

**Please wait for a confirmation email before making payment- just to ensure I have the TENS available when you need it (unless I have already confirmed availability for you).

If the hire is urgent you can always call me on 0414 918 114. Thank you!

PAYMENT DETAILS:

Bank Transfer-

Felicity Donaghy

BSB-083646 ACC-538570988

PayID- felicity@mybirthgeelong.com.au

Thank you for hiring from My Birth Geelong!
Should be Empty:

TENS Hire Form