Home / Trial Intake Form

Start Your Assistive Technology Trial Request

This is Step 1 of 2.

Please complete this short form to get started. This form should take less than 5 minutes to complete, and ensures we have the essential information to initiate a trial.

Once submitted, you’ll receive a confirmation page and an email with a unique link to complete Step 2. This process helps us understand your needs and prepare a safe, well-supported trial experience.

Whether you’re a therapist referring a client or a self-referring individual or family member, we’re here to help.


Need help? Contact us at 1300 008 267.

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Customer support

Email us with any questions or enquiries. We would be happy to answer your questions. We'll do everything we can to respond quickly.

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Assistive Technology Professionals

Made up of more than 40 assistive technology professionals (ATPs), our clinical team are specialists in assistive technology and equipment prescription.

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Locate a showroom

Independent Living Specialists is Australia's largest medical and homecare equipment supplier with over 50 showrooms across New South Wales, Victoria, Queensland and South Australia.