By submitting this form, I acknowledge that all items borrowed must be returned in similar condition and that all loaned items are subject to review by the What’s Next Committee. I further understand and agree that Hearts of Miromar is not responsible for any malfunction, damage, or issues that may arise from the use of a borrowed item.

By submitting this form, I understand that I am offering to lend a medical supply item(s) to the Hearts of Miromar Lending Medical Equipment Registry. I acknowledge that the item will remain in my possession until matched with a borrower, at which time a member of the What’s Next Committee may assist with pickup and delivery. While every effort will be made to ensure the item is returned in similar condition, I understand that Hearts of Miromar, the What’s Next Committee, and its members are not responsible for any damage, loss, or normal wear and tear that may occur during the lending period. I also acknowledge that all borrowers agree to return items in similar condition, and that all items submitted to the Lending Medical Equipment Reigstry are subject to review and approval by the What’s Next Committee.