Return Equipment Online Form

Label
1. Return Equipment to the Community Equipment Store
  
  You can use this form to arrange to return equipment to the Community Equipment Store in West Lothian.
  
  Note that although we install bannisters and hand rails, we cannot accept returns of these.
  
  We also cannot accept returns of items for any other council or NHS service.
  
  This form should take less than five minutes to complete.
2. Full Name
3. Your address
  1. Your Address
  3. Cannot read property 'addressString' of undefined
  4. Your Address
    
    OSG Postcode Search (Custom drop-down list)
    
    Postcode
    
    Address
4. Date of Birth
  
  Day
  
  Month
  
  Year
5. Phone Number
  We'll use this to arrange a time to collect your items. If you provide a mobile number we will text you.
6. Email Address
7. Tell us what items you are returning.