Equipment Loan Form

  • Return wheelchairs directly to us on the return date.
  • Wheelchairs are heavy. Bring along someone who can carry it up a flight of stairs.
  • Maximum weight is 250 lbs. Let us know in the comments if you need a larger chair.
  • Loans are for members of the Jewish community of Highland Park and Edison, New Jersey.

    Your name

    Your email

    Your phone

    Equipment needed

    Pickup date

    Return date

    Message (optional)