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Directory Results for I, the above named, take full responsbility for the equipment rented, and agree to pay the full repair cost or replacement value of said equipment listed aboveif damaged or lost while in my possession to I, the above patient, do hereby attest that the ination regarding my health is true to my knowledge - dhrs gov

I, the above named, take full responsbility for the equipment rented, and agree to pay the full repair cost or replacement value of said equipment listed aboveif damaged or lost while in my possession
I, the above patient, do hereby attest that the ination regarding my health is true to my knowledge - dhrs gov