ELLE TENS RENTAL AGREEMENT
Thank you for choosing to rent the Elle TENS unit from Alpha Childbirth. Please email
if you have questions about these services.
The following rental agreement will take place between Alpa Childbirth and and the individual named below.
When you reach 37 weeks you can use your Elle TENS Unit for pain relief before, after, and during labour and birth. Your Elle TENS unit will be delivered to you at any time beginning 21 days prior to your due date.
Our Elle TENS Unit rental cost is $90.00 for up to 40 days. Full payment is required to reserve your unit .
An additional fee of $15.00 per week or part week is incurred after the 40 day rental period has expired
. The rental plan begins when full payment and agreement are received by Alpha Childbirth.
Items included in Elle TENS Unit rentals are:
Elle TENS Unit
Pack of 4 Electrode Pads
2 Lead Wires + 1 Spare
2 AA Batteries + 2 Spare
Please contact Alpha Childbirth when the unit is ready for return. You can reach us at
. Elle TENS gel electrode pads should NOT be returned to Alpha Childbirth - please dispose of them.
If you have a cardiac pacemaker or suffer from epilepsy you must not use the Elle TENS Unit.
The Elle TENS must not be worn and or operated while driving a vehicle.
Do not operate a microwave while wearing the Elle TENS Unit.
The Elle TENS Unit must NOT be used in a bathtub or shower.
The Elle TENS Unit is for the sole use of the undersigned only.
Your rental has been cleaned, sanitized and inspected for damage and tested. You will receive it in working order. Any damage or breakage during the rental period will result in the full cost of replacement of the Elle TENS Unit being made by you which is up to $200.00. No refunds are offered, even if the Elle TENS Unit is not used.
Please read the full instructions before using the TENS unit. All risks involved in using the Elle TENS Unit are assumed by the undersigned.
I acknowledge that I have read this waiver and that I understand and accept all responsibility for the inherent risks to anyone and myself in my care with respect to the Elle TENS Unit.
I acknowledge that I do not suffer from a seizure disorder, use a cardiac pacemaker or intend to use the Elle TENS unit until I have reached 37 weeks gestation.
WAIVER OF LIABILITY:
I, the renter,
hold Alpha Childbirth responsible or liable for any injury or damage sustained as a result of misusing the Elle TENS unit.
Indicates required field
NAME (FIRST AND LAST)
BY ENTERING MY NAME BELOW, I THE RENTER, ACKNOWLEDGE THAT I HAVE READ AND AGREE TO THE ABOVE TERMS + CONDITIONS, RENTAL FEES, CANCELLATION + REFUND POLICY, PRECAUTIONS + WARNINGS AND WAIVER OF LIABILITY WHEN RENTING THE ELLE TENS UNIT FROM ALPHA CHILDBIRTH.
TYPE NAME HERE
ELLE TENS UNIT
LA BASSINE BIRTH POOL
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