Intake Form

Related Information

• Testimonials
• Partial Customer List for Freedom Bed
• Clinical Trials
• Freedom Bed Case Studies and Articles
• Related Articles
• Letters of Medical Necessity
• Intake Form

Prior to ordering the Freedom Bed, please help us to better serve you by filling out and submitting the Intake Form (53K PDF file).

This form will assist us to determine if there are any contra-indications, and allow us to recommend the most appropriate model and options based on your particular needs, as well as prepare for installation and delivery issues.

Upon completion of the Intake Form, please fax it back to ProBed at
604) 852 3097.