Borrow Equipment
Instructions for Agencies Delivering Health Closet Equipment
Instructions for Agencies
DRAFT
Here,“agency” means a hospital, clinic, senior living community, nursing home, or other healthcare provider that takes equipment from the Health Closet and delivers it to a patient or other end user (the “recipient”).
The Upper Valley Health Closet Lions Club Foundation (the “Foundation”) requires every equipment recipient, or the recipient’s authorized representative, to sign a loan agreement that includes the Foundation’s Liability Release and Express Assumption of Risk form (the “Waiver”) unless doing so is not reasonably practicable. The requirement applies whether the Foundation provides the equipment directly or whether an agency delivers it.
The Waiver language is intended to cover both the Health Closet and, when applicable, the delivering agency, although the Foundation cannot assure the efficacy of that language.
Required Steps for Agency Staff
Obtain the loan agreement and Waiver. Copies are available at the Health Closet or online: Get the Form
Confirm availability. Verify that the equipment is in stock and reserved for your agency. You can phone or send a message using the contact information available online: Contact Us
Complete the agreement. Enter the recipient’s name, the recipient’s contact information, a description of the equipment, and your agency’s contact information.
Obtain the required signature. Ask the recipient or the recipient’s authorized representative, such as a friend or family member, to sign the Waiver.
If Your Agency Will Pick Up Equipment from the Health Closet
Bring the signed loan agreement and Waiver when you pick up the equipment.
In an urgent situation, the Health Closet may, at its discretion, release the equipment before receiving the signed documents. However, the agency named on the agreement must provide the signed documents as soon as possible after pickup.
If You Want the Health Closet to Deliver Equipment to Your Site
Return the signed loan agreement and Waiver to the Health Closet as soon as possible. You may email copies to info@healthcloset.org
After the Health Closet receives the signed documents, staff will schedule the delivery.
In an urgent situation, the Health Closet may, at its discretion, schedule delivery before receiving the signed documents. However, the agency named on the agreement must provide the signed documents as soon as possible after delivery.
Important: Your agency must follow these instructions to remain eligible to receive equipment for delivery to recipients.