TENS Rental Application
Your TENS rental includes: The Elle TENS unit, a pack of 4 individual use electrodes, lanyard, 3 sets of leads, 2 sets of batteries, instruction manual, and carrying case.
登入 Google 即可儲存進度。瞭解詳情
Your first and last name, partner's first name (in case they are coming to pick it up) *
When is your due date? *
MM
/
DD
/
YYYY
What is your mailing address? *
Which email address shall we use? *
What phone number can you be reached at? *
Have you ever used a TENS machine before? *

RENTAL TERMS AND CONDITIONS

1.    The TENS machine is supplied on the understanding that it will be used only by the person whose name appears on the registration form (further referred to as the “Renter”) and is not transferable between individuals. 

2.    The renter will have discussed the use of a TENS machine with the medical practitioner in charge of their care and will have received the practitioner’s approval.

TENS cannot be used:

o  On open wounds that would interfere with the placement of pads;

o  If Renter has history of epilepsy or seizures;

o  If Renter has a pace maker;

o  While labouring in water (but these are easily taken on and off before and after water use);

o  Before the 37th week of pregnancy (unless labour has begun).

3. TENS will be used following the instructions provided. Please view this video for reference.

4. TENS can be placed on limbs during testing or practice after 36 weeks of pregnancy. Use can begin during early labour. Electrodes should not be placed on broken or inflamed skin.

5. TENS units are to be kept away from water at all times. If you wish to have a bath, shower or enter your birthing pool, you must first turn off the TENS unit and remove the electrodes from your skin.

6. Birth Beginnings shall not be held responsible or liable for any injury or damage sustained as a result of misusing the TENS unit.

7. The success of TENS is in no way guaranteed.

8. All pieces of the original package MUST be returned, this includes expired batteries.

9. The rental period is for 5 weeks (35 days). If your rental period expires before you have given birth, an extension can be accommodated at no extra cost if agreed prior to the expiry date of rental. Should the unit not be returned by the last day of the rental period (unless otherwise agreed with Birth Beginnings), an additional $15 will be charged for each partial or full week until the unit is returned, or the renter has been charged $200 in late fees, which is the replacement cost of a unit.

10. The pickup and return of the TENS unit to Birth Beginnings rests with the renter.  

11. No refund will be provided after the TENS unit has been dispatched to Renter or for non-use of a machine.

*
必填
How did you hear about our TENS rental?
The five week rental fee is $75 + HST ($84.75). The TENS unit will be picked up and returned to Birth Beginnings at 4187 Sutherland Cres, Burlington, ON, L7L 5G3. Please choose a payment option. *
提交
清除表單
請勿利用 Google 表單送出密碼。
Google 並未認可或建立這項內容。 檢舉濫用情形 - 服務條款 - 隱私權政策