Mobility Aid Hire Form

This mobility aid is the property of Hawthorn Physiotherapy Clinic and by taking it you agree to the following terms:

  1. I agree to return this mobility aid to Hawthorn Physiotherapy Clinic at 1 Launder Street, Hawthorn, when I have finished with it between 8am to 7pm, Monday to Friday, at which time a hire fee will be payable.
  2. The fee will be $15 per week for the first 3 weeks, or part thereof, and $10 per week or part thereof for each week after the first 3 weeks.
  3. If I have the mobility aid in excess of 9 weeks, the mobility aid will be considered purchased by myself, and in such instance, I give Hawthorn Physiotherapy Clinic the authority to debit $100 from the credit card elected below.
Mobility Aid Hire Form