EQUIPMENT RETURN/ DONATION FORM

EQUIPMENT RETURN/ DONATION FORM

Snoosz is dedicated to improving the lives of our clients and their families through the redistribution of used medical equipment and supplies, at no cost to them. Your donations are are desperately needed. MEDICAL EQUIPMENT CAN BE DONATED ON THURSDAY'S 9 am - 4 pm ( Staff do not arrive until 1PM) and SATURDAY'S 8am -10 am in the designated area marked in the photo below. NO APPOINTMENTS NECESSARY. On Thursday's Please DO NOT return/donate when there is pending inclement weather as your return/donation will become ruined and be discarded. Staff do not arrive until 1 pm to collect the returns/donations. Please return/donate equipment ONLY in the designated area, and only on designated days. There is a preschool on our property and random donations of medical equipment left in undesignated areas or on days other than DONATION DAYS, puts the children and others at risk.
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name*

First NameLast Name
Please check off EACH of the following boxes to indicate your acknowledgement

I have not donated medication of any kind. This includes needles, such as insulin syringes.I will only donate equipment that is clean and in good repair.I understand Snoosz.com cannot accept certain items at this time.
Which day will you be returning/donating medical equipment?*

Thursday 9am-4pmSaturday 8am -10am
DONATION RECEIPT NAME*
I am returning/donating the following items to Snoosz.com The following items are clean and in good condition. I am returning/donating equipment that I would feel comfortable receiving.*

WheelchairTransport ChairElectric WheelchairElectric ScooterHospital BedHospital Bed MattressBed RailsAir MattressSeat CushionRolling Hospital TableHoyer LiftRollatorWalkerCaneCrutchesShower SeatTub Transfer BenchRaised Toilet SeatCommodeKnee ScooterDiapersBed PadsGrabber/ReacherMisc. Wound Care ProductsOther
If you checked other, please tells us what you are donating.Your answer
If you donated diapers, bed pads, or other items in bulk, please indicate the number below:
Should be Empty: