Curtain Recycling Collection Service

Practice/Hospital/Clinic Name *

Practice/Hospital/Clinic Address *

Including postcode

Contact Name *

Contact Email *

Where do you currently buy your Privacy Curtains from?

Are you currently using Marlux Medical Curtains? *

How many curtains do you require? *

Include the number of curtains you need for one exchange

Curtain Colour *

Please provide a curtain code where possible

How often do you change your curtains? *

Last curtain exchange date

Additional Information

Please add any further information including offer codes.

Curtain Hook Type *

Please select the hook type(s) you require

Your email *

Field #2