Order Request Form

 

Most of our cushions are built to order, so please fill out the form below, and a representative will be in contact shortly to gather additional information and initiate your order.

 

Having relevant information available when our specialists contact you — such as the cushion style you currently use, cushion/wheelchair seat pan size, your current height and weight, and relevant medical conditions — is extremely helpful. This information assists us in personalizing your cushion and making certain is perfect for you.

 

Please fill this form to the best of your knowledge so we may better assist you. This is not an official order form, only an initial request, please do NOT include any credit card information in this form.

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2016 EASE Seating Systems   866-376-1878

MEDICAL DISCLAIMER

 

Ease Alternating Pressure Seat Cushion products are designed to increase seating comfort and promote circulation with it's "alternating pressure" capabilities. This product is not designed to diagnose or treat any medical problem and has not been tested by the FDA. Testimonials on this site are actual customers' experiences, in their own words, and are used with permission. Your results may vary.

2017 EASE Seating Systems   |   All Rights Reserved   |   866-376-1878

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