Arrange a collection for the Integrated Community Equipment Service Arrange a collection Note: Questions marked by * are mandatory *This is a mandatory field. The name and address of the person the equipment has been issued to: *This is a mandatory field. What items/equipment would you like us to collect? *This is a mandatory field. Please advise why the equipment is no longer required: Please Select An Option Duplicate IssueMoving out of areaNo longer fit for purposePatient passed awayEquipment no longer required/surplus *This is a mandatory field. Name of person completing this form: *This is a mandatory field. Preferred contact number: Email address: *This is a mandatory field. Collection address, including postcode: You are here: Page 1 of 2