1. The Lessor and Lessee together are referred to as the "Parties". The Lessee (patient named above) is renting the SleepImage Ring, Large; SN: 22122C4360 or SN: 23092C0156 (“Equipment”), which is valued at approximately $300.00 (“Casualty Value”).

2. Rental Period (“Term”): This Agreement starts on the Start Date, and the SleepImage Ring should be picked up on the first business day, used overnight, and returned the following business day by 5:00 pm Mountain Time, the End Date.

3. Rent and Deposit: If the SleepImage Ring is returned on time, there is no rent due. A rental charge of $20.00 per day will be applied for each calendar day or portion thereof after the End Date until the Equipment is returned (the "Rent"). A $50.00 deposit (“Deposit”) must be provided (via credit card, check, or cash) before taking possession of the Equipment. This Deposit will be refunded within 24 business hours at the end of the Term if all obligations under this Agreement are fulfilled.

4. Equipment Pickup: The Lessee is responsible for picking up and transporting the Equipment from Beehive Comprehensive Clinic Inc. at their own expense and risk.

5. Equipment Usage: The Lessee must use the Equipment carefully, in compliance with the manufacturer's guidelines, and only be used for its intended purpose. Any alterations, modifications, or attachments to the Equipment must have prior written consent from the Lessor.

6. Warranties: The Equipment will be in good working order upon delivery.

7. Loss and Damage: The Lessee is responsible for any loss, theft, damage, or destruction of the Equipment. If the Equipment is lost or damaged, the Lessee must pay all unpaid Rent for the Term and the Casualty Value of the Equipment.

8. Ownership: The Equipment remains the property of the Lessor. 

9. Equipment Return: At the end of the Term, the Lessee must return the Equipment to Beehive Comprehensive Clinic Inc. at their cost and risk. Failure to return the Equipment within 7 days of the end of the Term results in payment of unpaid Rent beyond the agreed upon Term, the Casualty Value of the Equipment, and an additional 10% of the Casualty Value.

10. Insurance: No insurance for the Equipment is required or offered under this Agreement.

11. Indemnity: The Lessee will indemnify and hold the Lessor harmless from any claims, actions, expenses, and liabilities related to the Equipment's use.

12. Default: Failing to pay any amount due or breaching obligations under this Agreement constitutes an event of default.

13. Remedies: In the event of default, the Lessor can pursue various remedies, including declaring the entire amount due, using the Deposit to cover amounts owed,  charging the credit card left as a Deposit for taking legal action, taking possession of the Equipment, terminating the Agreement, or seeking other legal remedies.

14. Entire Agreement: This Agreement represents the entire understanding between the Parties and supersedes any previous agreements.

15. Governing Law: This Agreement is governed by the laws of the State of Utah, regardless of where legal action may be initiated.

16. General Terms: Electronic and facsimile signatures are considered binding and equivalent to original signatures.

17. Notice to Lessee: This is a lease, not a purchase. Please read this Agreement carefully before signing. You will receive a copy of this Agreement via email.

 

18. Medical Insurance Billing: Beehive Comprehensive Clinic Inc. participates in most insurance plans, including Medicaid and Medicare. If the Lessee is not insured by a plan contracted with Beehive Comprehensive Clinic Inc., self-pay rates are available and are collected at the time the ring is picked up. The Lessee is obligated to contact their medical insurance company with any questions regarding sleep study coverage.

 

19. Study Billing Information: The sleep study is billed as follows: CPT code 95800: Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg. by airflow or peripheral arterial tone), and sleep time. As the Lessee, I understand this is a screening study and additional sleep studies or a referral to a sleep specialist may be required to formalize a diagnosis if the screening study indicates abnormalities which require further investigation.

I agree with the terms and conditions of the Oximetry Sleep Ring Rental Agreement.