Please fill the form accurately with as many details as possible. Missing information may lead to a delay in your rental reservation. All fields marked with a red star must be completed in order to submit the rental reservation.

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    Rental Reservation Form

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    Rentals are month-to-month and renew automatically until cancelled — see our Rental Agreement and Refund & Cancellation Policy. Delivery, setup, and pickup fees are quoted upfront and are non-refundable once service is rendered. Homepro Medical may offer a discount for payment by bank transfer (ACH); any discount is shown on your quote before you pay.

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