Travel Rental Form

Fill in the form below to receive more information about our equipment rentals. (Pricing Details below form)

Equipment Rental Prices

Equipment	Daily	Weekly	Monthly	Weekend
Wheelchair - Standard or Transport	$20.00	$80.00	$160.00	$50.00
Wheelchair - Power	$50.00	$200.00	$400.00	$125.00
Beach Wheelchair	$40.00	$160.00	$320.00	$100.00
Power Operated Vehicle	$40.00	$160.00	$320.00	$100.00
Rollator	$12.50	$50.00	$100.00	$31.25
Walker	$7.50	$30.00	$60.00	$18.75
Hydaulic Lift	$12.50	$50.00	$100.00	$31.25
Sling for Hydraulic Lift	$102.00 (Purchase)
3 n 1 Bedside Commode	$15.00	$60.00	Purchase	$37.50
Bucket for 3 n 1	$10.00 (Purchase)
Shower Chair	$10.00	$40.00	Purchase	$25.00
Oxygen - Tank(s)	$20.00	per tank, any size
Oxygen - Concentrator	$50.00	$200.00	$300.00	$100.00

NOTES:

1. All rentals include Applicable Sales Tax.

2. Delivery/Pick-up charge $15.00 each way.

3. There is a $20.00 charge for any deliveries that are scheduled and are not

completed due to the renter not showing up or for giving incorrect information.

4. All cancelations of reservations must be made at least 48 hours in advance if not

all rental fees will be charged to the credit card given for the reservation.

2. All manual wheelchairs come with standard legrests,

unless Elevating Legrests are requested.

3. Renters must specify if a trapeze bar will be required with a hospital bed.

4. All hydraulic lift rentals come with out a sling renters must provide or purchase a

sling for their lift.

5. All 3 n 1 bedside commodes and shower chairs must be cleaned before returned.

6. All 3 n 1 bedside commode rentals must purchase a

Non-Returnable bucket for rental .

7. A Doctor's Prescription with rate of flow is required for all Oxygen rentals