Comfizz Prescription Request

Fields marked with an * are required

May we contact you?

As we value your privacy we promise NOT to bombard you with marketing


Customer information


Garment information

First Garment


Second garment if applicable


Third garment (if applicable)


Fourth garment (if applicable)


Your Doctor and Surgery information

Delivery company who deliver your appliances etc. State 'none' if you don't use one.


Prescription Request Form
(UK Only)

Let us organise your prescription for you! Just fill out this simple online form below, click submit, then sit back and wait for your order to arrive.

product available on prescription

NOTE: only products with this symbol are available on prescription (UK only)

 

 

New Customers

Please try just a couple of garments to check fit and suitability before requesting more on prescription.

Existing Customers

If you have already tried Comfizz and you know what you want there’s no need to place a small order. Just go ahead and request what you need. Most GP’s are happy to prescribe upto 6 garments a year.