Do you have any problems with getting the signed forms back?

When are people asked to sign the loan agreement? Is it presented to them when they receive the equipment? Is it sent before or after the patient receives the equipment?

Antoinette Verdone, MSBME, ATP

Assistive Technology Specialist

The ALS Association, Greater New York Chapter

116 John Street, Suite 1304

New York, NY 10038

Phone: 212-720-3054

Fax: 212-619-7409

Email: xxxxxx@xxxxxxxxxx

www.als-ny.org

"One cannot consent to creep when one has the impulse to soar" -- Helen Keller

From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Ann Hoffmann
Sent: Monday, November 17, 2008 9:19 AM
To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
Subject: RE: [Assistive Technology] Equipment Loan Liability

The MN Chapter mails a Lease for Loan Agreement to all PALS registered in ALSA MN Chapter explaining in detail the terms in which the individual is going to keep, maintain equipment, and contact the chapter should something happen to the equipment. When equipment is no longer used, individuals are asked to return it as soon as possible so others may use it. In addition to this form, we have a separate Hrbek-Sing Loan agreement we have individuals sign and receive a copy to keep for their records of the equipment (AAC devices, switches, headpointing systems, etc.) loaned that is later entered in a database at the ALSA MN Chapter.

Hopefully this is helpful!

Ann Hoffmann| ALS Associatin MN Chapter, Coordinator for the Hrbek-Sing Communication and Assistive Device Program | PH: 763-520-0445 |

Fax: 763-520-0355|Courage Center | 3915 Golden Valley Road | MPLS, Minnesota 55422
xxxxxx@xxxxxxxxxxxxxxxxx | CourageCenter.org
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From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Antoinette Verdone
Sent: Friday, November 14, 2008 2:44 PM
To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
Subject: [Assistive Technology] Equipment Loan Liability

I have a question about loan closet liability. This probably is more relevant for DME.

What are chapters doing as far as having patients sign some sort of agreement absolving the chapter of any liability of the use of the loaner equipment?

If you have an agreement that is signed, do you have people sign before they get equipment? If not, do they sign it after they get the equipment, or at another time? What do you do if you do not receive a signed agreement from the patient?

I would like to hear what others are doing.