Either:
- select 'Begin this form' (below). You don't need to sign in, as long as you complete each page in less than 10 minutes.
- or register and sign in with myaccount. If you are signed in, the form will save and you can finish it later. Your contact details will be already filled in.
This request is for anyone who is older and/or disabled, who lives in Midlothian and looking for MIDCARE equipment to help with living at home.
You can complete this form:
- for yourself
- on behalf of someone else (with their consent)
- on behalf of someone else (without consent if you have concerns about their wellbeing).
If your request is urgent then please call us:
- 0131 271 3900 during office hours (Monday - Thursday 9:00-17:00, Friday 09:00-15:30)
- 0800 731 6969 out of office hours.