Rental Refund Request Form

HealthHub Solutions is committed to customer service and transparency. Please provide as much information as possible in the form below and allow up to 15 days for refund processing if qualified.

"*" indicates required fields

Your Rental Bed

[HOSPITAL]

[FLOOR]

FLOOR

[ROOM]

ROOM

[BED]

BED

Change bed information

Hospital Name

Floor Name

Room Number

Bed Number

Rental Details

Patient Name*

Order ID*

Credit Card Holder's Name*

Email Address*

Phone Number

Rental Start Date

Reason for Refund*

Please let us know the reason why your refund is being requested*

Please note: If service ticket number is included in your submission, the refund is based on the date that the service issue was reported. If you do not have a service ticket number, your refund request will be based on the date that this form is submitted.

Please provide us with your service ticket #

3 min characters, 6 max characters

If your service issue has not yet been reported, please use this form to do so. (https://healthhubsolutions.ca/service-request/) Once you have submitted the ticket, enter your service ticket ID above.

New Hospital

Please let us know which hospital you have moved to, as we service many hospitals across Canada, and may be able to continue your service at your new location.

Please provide us with your new room or select "Other" if you do not see the option in the list.

New Floor*

New Room*

Please provide us with your new room*

Rental Refund Request Form

Your Rental Bed

Rental Details

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