RENTING MEDICAL EQUIPMENT
Name of Patient (if not renter): kNEE SCOOTER RENTER
Date of Birth:
Email: [email protected]
8340 Northfield blvd #1680
denver, CO 80249
Major Credit Card Holder: No
Renter must be a Major Credit Card Holder and sign this Rental Agreement.
Dealer will rent an at home to Renter signing this agreement; subject to all the terms set forth in this Rental Agreement and Renter agrees to the following:
- The medical equipment is the property of Dealer and is in excellent condition. Renter shall return equipment in the same condition as when received from Dealer, at the end of the rental period or upon the demand by Dealer (if necessary). Dealer may repossess the medical equipment without demand at any time if it is used in violation of the terms of this agreement.
- Dealer is not liable or responsible for the loss, damage or theft of medical equipment during the rental term. Renter assumes all risk/responsibility of loss, damage or theft and waives all claims against Dealer by reason thereof and Renter agrees to hold Dealer harmless from and to defend and indemnify Dealer against all claims based upon or arising out of such loss or damage.
- Renter assumes all risk and liability for any loss, damage or injury, including death, to persons or property of Renter or others during the use or operation of the medical equipment.
- Renter is responsible for the medical equipment and will reimburse Dealer, the Legal Owner of Equipment, up to the full cost of replacement upon demand for any damage, loss, theft, or destruction of the medical equipment. The Renter understands and authorizes that Dealer will charge the credit card on file for any repair or replacement costs of the medical equipment deemed necessary.
- Under no circumstances shall the medical equipment be used, operated by and person:
- under the age of 18 (unless waiver is signed by parent or guardian)
- while under the influence of intoxicants or narcotics
- in any unsafe/dangerous manner
- Renter shall defend, indemnify and hold harmless Dealer, all of their agents, officers, servants, and employees from and against any and all losses, liability claims, damages, injuries, demands, actions, and causes of action whatsoever, arising out of or related to any loss, damage or injury claimed by persons that may arise from the use, operation or driving of the medical equipment, provided that such loss or damage was not caused by the fault or gross negligence and willful misconduct of Dealer or its employees.
- Renter assumes all costs and expenses of every kind and nature, including legal fees and disbursements arising out of and in connection with the use or operation of the medical equipment.
- Dealer assumes no liability or responsibility for any acts or omissions of Renter or of Renter’s agents, servants, or employees.
- Renter shall notify Dealer immediately of any accidents and damage resulting from the use or operation of the medical equipment.
- Renter agrees to pay all costs, expenses, and attorney’s fees incurred by Dealer in collecting sums due or in regaining possession of medical equipment or in enforcing or recovering any damage, losses, or claims against Renter.
- Renter of the medical equipment shall in no event be deemed the agent or employee of Dealer in any manner or for any purpose whatsoever.
- Any individual executing this Agreement as Renter in a representative capacity shall be bound personally, jointly, and severally, with a such fiduciary, corporation, or other entity as to all obligations, expressed or implied, arising hereunder.
- This Agreement shall be binding upon the heirs, next of kin, executors, administrators, and personal representatives of the undersigned Renter.
- We reserve the right to refuse renting to anyone if deemed necessary due to various reasons.
Estimated product replacement cost will be
Portable Rental Rates
*Deposit refunded when is returned.
Credit Card Payment Authorization
By signing this form, I acknowledge that I have read the rental agreement and understand the terms and conditions set forth herein. I also agree to the charges being made to my credit card and understand that if the rented item is not returned on the agreed-upon return date, additional charges will be incurred.