Get Red Cross Equipment Loan Form

Filling out the Red Cross Equipment Loan Form online is a straightforward process that helps ensure you receive the necessary equipment for your health needs. This guide will walk you through each section of the form, providing useful tips to assist you in completing it accurately.

Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to access the form and open it in your editing tool.
2. Begin by entering your personal information in the Client section. Fill in your last name, first name, phone number, birth year, gender, height, and weight. This information is critical to ensure that suitable and safe equipment is provided.
3. Complete the Address section by providing your full address, city, province, and postal code. Include your personal health number for reference.
4. If you wish to designate an alternate contact, fill in their name and phone number in the Alternate Contact section.
5. In the Equipment Selection section, choose the items you need by marking on the specific equipment options. For example, if you require an adjustable bath chair, indicate your preference for a version with or without a back.
6. Continue selecting equipment options by indicating preferences for other items like commodes, walkers, wheelchairs, and aids. Make sure to provide detailed specifications as requested.
7. Once you have finished selecting the equipment, proceed to the Referring Health Care Professional section. Enter their full name, signature, phone number, designation, and place of work.
8. Input the anticipated length of the loan and any additional information that may be relevant. Finally, fill in the referral date.
9. After reviewing all entered information for accuracy, you can save changes, download the completed form, print it, or share it as necessary.

Complete the Red Cross Equipment Loan Form online today to ensure you receive the equipment you need.