Please call to make sure we have the item in stock. Item can be placed on hold for 24 hours.


Client  (person using the equipment)   

  • Name, Address and Telephone Number

Responsible Party (must live in LA County)

  • Name, Address and Telephone Number

Contact Person (person not living with client or responsible party)

  • Name, Address and Telephone Number

Proof of Residence from client and responsible party (must show physical address)


Current CA driver’s license or State photo ID
Current utility bill (not older than 1 month)
Current rental agreement
Land-line phone bill [not cell phone] (not older than 1 month)
Current Social Security Statement Letter


* We cannot accept bank statements or any personal bills not noted above
* P.O. Box cannot be listed as the address for anyone on the application

Equipment is available on loan to any individuals who live within our service area.  That means the person who will be using the equipment must live in a city located within the San Gabriel Valley area; including Glendale, Burbank, La Canada Flintridge and several adjacent cities. The full list of cities we provide service for can be found here. We do check for proof of residency.

The equipment may be borrowed for in-home use only. That means it CANNOT be used for residents of skilled nursing facilities, nursing homes, or convalescent homes because these facilities have their own equipment. You will be required to provide a current driver’s license or some other government identification and complete a brief electronic application when you come into the office to pick up your medical equipment.