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Medical Equipment Loan Program

The Center has a variety of durable medical equipment items available for loans of up to three months. For community members recovering from surgery, wanting to do a “test run” with assistive equipment, or otherwise in need we can provide (as supply allows):

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  • Wheelchairs

  • Canes

  • Walkers

  • Shower chairs & benches

  • Steerable knee scooter

  • Bathroom safety equipment

  • Grabbers and other assistive devices

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To get started with an equipment loan, please fill out the form below and/or email us at info@normandalecenter.org. We will get back to you within business hours Monday-Thursday, 9:00 am - 12:00 pm.​​

Medical Equipment Loan Form

Please complete the form to help us facilitate the equipment loan process.

 

We will get back to you within business hours Monday-Thursday, 9:00 am - 12:00 pm.

Please check all that apply:
Are you the caregiver?
Yes
No
Can we contact them to offer support?
Yes
No
Is this the first time using our equipment loan program?
Yes
No
Gender of the equipment user:
Male
Female
Other
What type of equipment is needed?
Date when equipment is needed:
Month
Day
Year

I understand that employees of Normandale Center for Healing and Wholeness have not repaired or reconditioned this equipment in preparation for this transfer, and that any repairs, cleaning or other reconditioning are the recipient’s responsibility.  

 

I understand this equipment is being loaned to me “as is,” and I am assuming the entire risk as to the quality and performance of the equipment.  I agree to indemnify and defend Normandale Center for Healing & Wholeness from any liability arising from injury to person or property caused in whole or in part by this equipment.  

 

I agree to use this equipment as intended and will read and follow instructions describing proper use of the equipment.  I agree to return this equipment clean and in good condition.

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Date
Month
Day
Year
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