Hill DT Upholstery Order

To view product pricing, you must select a vinyl color below before products will appear.

"*" indicates required fields

Step 1 of 2

Order ID

Name*

First Last

Email*

Phone*

Shipping Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment method*

How will you be paying for this order?

Credit card purchase

Send a PO (purchase order)

Create a quote only (no payment required)

PO Number*

Please enter your PO number here.

Upload PO

If you have a copy of the PO, please upload it here. You still need to fill out the form below to match your PO.

Drop files here or

Max. file size: 50 MB, Max. files: 1.

Bill To:*

For example, your Hill dealer account or a hospital name.

Billing Address

Same as shipping address?

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Serial Number*

You'll find it on the front of the base skirting of your Hill table or chair. Please enter numbers only.

IMPORTANT: For serial numbers that begin with 87 through 99, you can only order COVERS, not full cushions.

Do you have a picture of your table?

Each order is checked for accuracy based on your specific table, so providing a picture will expedite the process of activating your order.

Drop files here or

Max. file size: 50 MB, Max. files: 5.

Matching original color?

Are you matching your original color or getting a new color?

Matching my original color

Getting a new color

Vinyl color*

Head

Thoracic

Pelvic

Foot

Flexi Strap Covers

Order notes

For example, do you want a different foam density on any of your cushions? Does your table have a custom feature we should know about?

Total