Please use the form below to request a booking. Our shopmobility team will then email you to confirm.

Name
Hire Location
Telephone (required)
Email Address (required)
I would like to book a
Date you wish to hire
Duration
We have a range of mobility scooters and wheelchairs (with differing weight capacities) available to meet the varying needs of our customers. To ensure the safe use of mobility equipment and for insurance purposes please tell us:
Your weight range
Additional Information
By submitting your enquiry you agree to Dial West Cheshire processing your data in accordance with our Privacy & Cookie Notice.
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