Accessible Accommodation Booking Service
Accessible Accommodation Booking Service
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you making this enquiry on behalf of someone else
*
No, I am enquiring myself
Yes, for a friend/family member
Yes, for a client
Guest's Name
*
First Name
Last Name
Guest's Email Address
*
example@example.com
Guest's Phone Number
*
-
Area Code
Phone Number
Property/Location
*
eg. 100 Hitchcock or Gold Coast
Check-in & Check-out dates
*
Accessibility/medical requirements
*
eg. Accessible Bathroom, Electric bed, Hoist or NILL
Number of Guests (12+)
*
Number of Children under 12
*
Number of rooms required
*
Do you need pet friendly accommodation?
*
No
Yes, dog friendly
Yes, cat friendly
Yes, other
How is the booking being paid?
*
I'm paying myself/self funded
Other (please add details in the field below)
Additional notes/enquiries
Are you coming with a carer, need an interconnecting room etc.
Would you like to subscribe to our newsletter?
Yes
No
Submit
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