Patient Resource Center

Serving Chicagoland and Central Illinois

Request FREE Quote

20066 N Rand Rd - STE C Palatine, IL 60074-2014 Phone: (847) 991-3600 Fax: (847) 359-4650

156A Lincoln Square Urbana, IL 61801-3438 Phone: (217) 355-7971 Fax: (217) 355-8619

Home
Catalog
What We Offer
Our Services
Home Modification
Resource Center
Newsletter
Contact Us

Resource Center

Medicare & Insurance Guide
Help for Patients & Caregivers
Glossary of Medical Terminology
Best of Medical Websites
Centro De Recurso Para Pacientes

Web Site Options:
Re-Size Your Text: Aa Aa Aa

Home Modification Assessment

Home

Contact Information

First invisible reverse captcha textbox to prevent spam. Second invisible reverse captcha textbox to prevent spam.

Third invisible reverse captcha textbox to prevent spam. Fourth invisible reverse captcha textbox to prevent spam. Fifth invisible reverse captcha textbox to prevent spam.

Name First Last	Contact Location:
Home Phone ### - ### - ####	Email Address
Alternate Phone ### - ### - ####	Alt Phone Type
Address Information Street Address City Address Line 2 State / Province / Region Postal / Zip Code Country
Who are you considering this product for:	How did you hear about us?

What products are you interested in?

Please check all that apply

Stairlift
Bathroom Modification
Wheelchair Lift
Home Modifications
Home Elevator
Ramps
Ceiling Mounted Lift

What would you like us to do?

Schedule a free in-home assessment
Call me to answer my questions
Send me more information

Additional Comments

Notes & Special Instructions

Home
Catalog
What We Offer
Our Services
Home Modificationn
Resource Center
Newsletter
Contact Us

Categories
Health Issues
Contact Us

MedServ Equipment Corp
20066 N Rand Rd - STE C Palatine, IL 60074-2014 Phone: (847) 991-3600 Phone: (847) 359-4650
- View Our Locations
- Driving Directions