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Medical Equipment Rentals to Keep Independence and Mobility

Medical Equipment Rentals to Keep Independence and MobilityMedical Equipment Rentals to Keep Independence and MobilityMedical Equipment Rentals to Keep Independence and MobilityMedical Equipment Rentals to Keep Independence and MobilityMedical Equipment Rentals to Keep Independence and Mobility

Thank you for choosing Pico Medical Equipment Rentals. Fill out the form below to get started.

Fill out the form with the information of the responsible party

Name*

Phone*

Email*

Height and Weight of User*

Delivery Address*

Billing Address & Name (if different)

Date of Delivery*

What Equipment is Needed?*

Duration (Week rate or Month Rate)*

Attach Photo ID

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**DISCLAIMER**

- Matching Payment and California ID required otherwise there will be a deposit.

-Equipment subject to availability, form submission is not a confirmation of delivery.

-Free local delivery determined once information is submitted and reviewed.

-Delivery restrictions may apply.

Toll: 800.676.0400

Local: 323.936.4104

kimberly@picomedical.com

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