Medical Equipment Loan Agreement
1. Lender Information
Lender Organization Name:
Contact Person:
Phone:
Email:
Address:
2. Borrower Information
Borrower Name:
Phone:
Email:
Address:
3. Equipment Details
Equipment Name/Type:
Model/Serial Number:
Quantity:
Condition:
4. Loan Period
Start Date:
End Date:
5. Terms & Conditions
The borrower agrees to:
- Use the equipment solely for its intended purpose.
- Return the equipment in the same condition as received (normal wear and tear excepted).
- Contact the lender in case of damage, malfunction, or loss.
- Release the lender from liability related to use of the equipment.
- Comply with all applicable laws and safety guidelines.
6. Signatures
Borrower Signature & Date