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Terms & Conditions
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  1. Sales Terms. Doctors Medical Rentals, Corp. (DMR) agrees to sell to the Customer and Customer agrees to purchase form DMR the equipment and/or supplies that is the subject of this Agreement under the terms and conditions herein.

  2. Rental Term. DMR agrees to rent to the Customer and Customer agrees to rent from DMR the equipment that is the subject of this agreement under the terms and conditions herein. Customer agrees to pay rental fees until the equipment has been returned to DMR. Customer shall be responsible for any loss or damage to the equipment. The equipment is and shall at all times remain the property of DMR, unless otherwise purchased by the Customer.

  3. General Terms. The signature affixed to this document consummates the transaction as of the date indicated and serves as acknowledgment that the equipment and/or supplies that are the subject of this agreement, have been inspected and accepted in satisfactory condition. Customer agrees to pay the stated fees for the equipment and/or supplies. DMR will credit the Customer for any payments received from any insurance company or third party payer. DMR is not the manufacturer of the equipment or the supplies and is not responsible for any defects. The warranties offered by the manufacturers are the only warranties that exist and DMR makes no warranties of its own, either express or implied. DMR did not prescribe the equipment or supplies and makes no representation regarding the benefits derived form the use of the same. In addition to any sums due by Customer hereunder, DMR is entitled to recover all cost and expenses in connection with the enforcement of this Agreement, including reasonable attorney’s fees, collection fees, an legal expenses and court cost at all pre-suit, litigation, bankruptcy, and appellate levels. A copy of this Agreement may be used in place of the original.

  4. Overpay Liability. DMR, as the supplier of services for the Customer, will assume unconditional responsibility for refunding overpayments resulting from the carrier not having received prompt notice of the return of the rented equipment.

  5. Authorization for Release of Current Address. Customer hereby authorizes the Social Security Administration to release his or her current address to DMR.

  6. Authorization for Release of Information. Customer hereby authorizes the release of medical information to any governmental or third-party payer or medical provider to determine medical benefits or benefits payable for related services.

  7. Assignment of Benefits. I request that payment of authorized Medicare, Medicaid or other private benefits be made to DMR for any services funished to Customer by DMR.