DME Equipment Rental (Subscription)

Medical Equipment Rental Request

Fields marked with an * are required
Name*

First NameLast Name
Patient's Date of Birth (required for validating payment through our secure text-to-pay feature)

MonthDayYear
Date
Phone*
Email*
example@example.com
Do you wish to receive email reminder notifications?*

YesNo
Would you like your equipment rental delivered directly to you? ( You must select the $10 delivery fee in the product list below)*

YesNo, I will pickup at the nearest Good Day Pharmacy
From Which Good Day Pharmacy Location will you be picking up?*

Eaton (180 S. Elm Avenue in Heritage Market)Fort Collins (2601 S. Lemay)Fort Collins (2001 S. Shields)Greeley (4239 Centerplace Dr Unit 1D)Johnstown (201 Johnstown Center Dr. in Hays Market)Longmont (1749 Main St)Loveland (2033 Boise Ave.)Wellington (7702 5th St)
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please note

We are able to deliver to most addresses in:
- Eaton
- Fort Collins
- Greeley
- Johnstown
- Longmont
- Loveland
- Timnath
- Windsor
Which Equipment will you be renting?*

Turning Knee ScooterWheelchairTransport ChairFront-Wheel WalkerFour-Wheel Walker (with seat) [NOW AVAILABLE]
TURNING KNEE SCOOTER

The Knee Walker is an excellent mobility device for foot or ankle injuries when the affected area cannot bear weight or has limited weight-bearing precautions. It can be a great long or short-term alternative to crutches or folding walkers that can have adverse effects, such as back or under-arm pain from extended use. The Knee Walker allows the user to maintain an active and more independent lifestyle which will help him/her progress to a quicker recovery.

The Knee Walker with 300 lb weight capacity is ideal to provide non-weight bearing mobility for ankle, foot, or Achilles injuries

- Easy maneuverability combined with locking hand brakes

- Easily adjusts for the left or right leg, steering column folds down for transport and storage

-Comes with 8” rugged wheels and contoured and padded knee platform

We love The Knee Walker because being on the go … while recovering from foot/ ankle/Achilles injury is long, uncomfortable, and very inconvenient. Stay mobile and recover better with the non-weight bearing The Knee Walker, equipped with locking hand brakes, rugged wheels, and a strong frame that supports up to 300 lb. It’s going to be a long 6-12 weeks … suffer less and move more.

EASILY COLLAPSIBLE TO FIT INTO VEHICLES

KNEE SCOOTER DIMENSIONS
STEEL WHEELCHAIR with FIXED ARMS AND FOOTRESTS

The Steel Wheelchair comes equipped with fixed full-length arms and swing-away footrests. It also features dual axle positions for quick seat height conversion and flame retardant black vinyl upholstery. There are industry-compatible accessories available for this product.

Weight Capacity - 300 Pounds

You should also carefully consider the actual weight and size of the wheelchair or transport chair, especially if there are lots of events and adventures in the plans.

Weight of Wheelchair - 35 Pounds

FRAME STRENGTH
Transport Chairs and Wheelchairs are made with the highest quality materials and workmanship.

UPHOLSTERY
The material is attractive and comfortable, the craftsmanship is excellent, and the quality will last through life’s many adventures.

FOOTRESTS
All Transport Chairs and Wheelchairs come with swing-away, removable footrests. They are easy to adjust and durable for resting the unique shapes and sizes of our feet.

EASILY COLLAPSIBLE TO FIT INTO VEHICLES

StANDARD WHEELCHAIR DIMENSIONS

What’s the main difference between a Wheelchair and a Transport Chair?
Wheelchairs can be self-propelled by the user and also pushed by the companion. The large 24” rear wheels with rims allow the user to self-propel. This feature does add more weight and bulk to the wheelchair. Transport chairs have smaller rear wheels (8” & 12”) so the user cannot self-propel and can only be pushed by the companion. Thus, the transport chair is both lighter and more compact than a wheelchair.
LIGHTWEIGHT TRANSPORT CHAIR

The product names says it all! These great chairs (and not the “Wheelchair” kind) are 1) Lightweight – so easy to lift and 2) Transport – they can take you just about anywhere. So, just because your legs can’t get you there doesn’t mean you can’t be there and be together. Living life to the fullest means being with the people you love and going where you want to go. We love transport chairs because they do just that. They are much lighter and more compact than traditional wheelchairs and that is a game-changer because you can take them just about anywhere.

Weight Capacity - 300 Pounds

Weight of Transport Chair - 18.6 Pounds

The Lightweight Transport Chair 17 inch has a lightweight aluminum frame and padded upholstery. It is foldable and has a quick-release fold-down back, as well as padded, fixed full-length arms for added comfort. This transport chair has locking rear wheels.

FRAME STRENGTH
NOVA Transport Chairs and Wheelchairs are made with the highest quality materials and workmanship.

BEST BRAKES
Whether it is the locking hand brakes on some models or wheel locks on others -NOVA has the best brakes around!

UPHOLSTERY
You can see and definitely feel the difference with NOVA’s seating upholstery. The material is attractive and comfortable, the craftsmanship is excellent, and the quality will last through life’s many adventures.

FOOTRESTS
All NOVA Transport Chairs and Wheelchairs come with swing-away, removable footrests. They are easy to adjust and durable for resting the unique shapes and sizes of our feet.

EASILY COLLAPSIBLE TO FIT INTO VEHICLES

What’s the main difference between a Wheelchair and a Transport Chair?
Wheelchairs can be self-propelled by the user and also pushed by the companion. The large 24” rear wheels with rims allow the user to self-propel. This feature does add more weight and bulk to the wheelchair. Transport chairs have smaller rear wheels (8” & 12”) so the user cannot self-propel and can only be pushed by the companion. Thus, the transport chair is both lighter and more compact than a wheelchair.
FRONT-WHEEL ROLLING WALKER

The adult folding walker has a lightweight aluminum frame and a two-button release for great security. The walker folds to 4″ in width for easy transport and storage.

Weight Capacity - 300 Pounds

Approximate User Height - 5'4" - 6'2"

Weight of Folding Walker - 5.75 Pounds

EASILY COLLAPSIBLE TO FIT INTO VEHICLES

Overall Dimensions (High): 24.5″w x 19.5″d x 38.5″h
Overall Dimensions (Low): 23.75″w x 18″d x 32.5″h
Height Adjustment: 32.5″ – 38.5″
Width Between Handles: 17.75″
Overall Footprint (High): 24.5″w x 19.5″d
Overall Footprint (Low): 23.75″w x 18″d
Overall Dimensions Folded: 23.5″-24″w x 4″d x 33.25″-39″h
FOUR-WHEEL WALKER WITH SEAT

Live Life to the fullest with your Four-Wheel Walker – the very best in Rolling Walkers. Improve your overall mobility, safety, and independence.

Locking Hand Brakes

NOVA’s patented hand brakes are designed for maximum comfort and control. They allow users to easily control their speed by pulling up and engaging the parking brake by pushing down. Users with weak or small hands need not worry - our hand brakes are the best and easiest to use. Most come with reflectors for safety and good looks!

Weight Capacity - 275 Pounds

Approximate User Height - 4'9" - 6'0"

Weight of Transport Chair - 18.5 Pounds

Walkers are NOT one size fits all.

To determine the correct seat height – sit on the seat with your back to the backrest. Your feet should both be flat on the ground with your thighs resting comfortably on the seat. Make sure your weight is below the listed weight capacity (275 pounds) and you can sit comfortably between the handles.

EASILY COLLAPSIBLE TO FIT INTO VEHICLES

Overall Dimensions (High): 24″w x 27.75″d 37.75″h
Overall Dimensions (Low): 24″w x 25″d x 29.75″h
Overall Dimensions When Folded: 35.75″-44.75″h x 24″w x 12.25″d
My Products*
Categories:All

All

Turning Knee Scooter

Wheelchair

Front Wheel Walker

Transport Chair

Four Wheel Walker
prevnext( X )
Home DeliveryPlease select this if you indicated that you would like your equipment delivered to you.
$10.00



Turning Knee Scooter

WEEKLY Turning Knee Scooter Rental (7 Days)
$20.00



BI-WEEKLY Turning Knee Scooter Rental (14 Days) - 12% SAVINGS
$35.00



MONTHLY Turning Knee Scooter Rental (31 Days) - 44% SAVINGS
$50.00



6 WEEK Turning Knee Scooter Rental (42 Days) - 50% SAVINGSThe standard recovery period after knee replacement or other surgical procedures is 6 weeks.
$60.00



Wheelchair

WEEKLY Wheelchair Rental (7 Days)
$40.00



MONTHLY Wheelchair Rental (31 days) - 50% SAVINGS
$90.00



WEEKLY Wheelchair Rental w/Elevated Legs (7 Days)
$60.00



MONTHLY Wheelchair Rental w/Elevated Legs (31 Days) - 50% SAVINGS
$110.00



Front Wheel Walker

WEEKLY Front Wheel Walker (7 Days)
$30.00



MONTHLY Front Wheel Walker (31 Days) - 45% SAVINGS
$70.00



Transport Chair

WEEKLY Transport Chair Rental (7 Days)
$30.00



MONTHLY Transport Chair Rental (31 Days) - 45% SAVINGS
$70.00



Four Wheel Walker

WEEKLY Four-Wheel Walker (7 Days)
$40.00



MONTLY Four-Wheel Walker (31 Days) - 50% SAVINGS
$90.00



Subtotal

$0.00

Tax

$0.00

Total

$0.00
Enter the date you wish to receive the medical equipment *

MonthDayYear
Please allow 24 hours to process request. If you're needing equipment before next busniess day, please call your local Good Day Pharmacy.
How did you hear about us?

Your Provider/PhysicianFacebook/Social MediaGoogle/Online SearchFriendPast CustomerRadioOther
Provider Name

First NameLast Name
If the equipment is lost or broken beyond repair, customer will pay the price of the equipment to replace, plus shipping and handling. (please initial)*
If the equipment is returned and needs to be repaired because of damage beyond use, the customer will be charged for parts and labor of repair. (please initial)*
If the equipment is returned and is visibly dirty, the customer will be charged a $25 cleaning fee at the time of return. (please initial)*
If the equipment rental is cancelled, the customer will be charged a $10 restocking fee at the time of return. This is to accommodate the time and resources spent delivering equipment between locations. (please initial)*
Signature - Upon submitting, we will process your order! *

Clear
Please note that you will receive a text message with a secure link to provide payment through our text-to-pay feature. Once the payment is completed, the rental equipment will be ready for pickup or delivery, based on the preference you indicated. Thank you for choosing our services!

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Medical Equipment Rental Request