Medical Liability Release Form

* Please note that completed forms expire after 1 year.*

In order to rent a Knee Coaster walker each customer will be required to complete the following release form.  Please complete this form before placing your rental order.

©2017  All rights reserved. 

Fax 844-734-2233

  • Facebook Social Icon
  • Twitter Social Icon
  • Google+ Social Icon
  • Pinterest Social Icon
  • Instagram Social Icon
  • YouTube Social  Icon