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Cruise Rental Form

Home Equipment Rental Cruise Rental Form

  • = Required

  • Referral Information

  • Contact Information

  • Cruise Information

  • Select if in handicapped room

  • Equipment

  • Selecting an item will display the 3, 4, 7, 8 or 9 night rental rates.

    **Price does not include delivery/pick-up charge as item is expected to be used with other equipment being rented. We have many others items for sale and/or rent available. Please contact us for more information.
    Delivery to Orlando Airports's/Resorts (1-way). The fee across the board is $135

  • wheelchair
    Standard Wheelchair
  • Portable Oxygen Set-up
    Portable Oxygen Set-up
  • wheelchair
    Std. Wheelchair w/Elevated Leg Rests
  • E-Tank Refills
    E-Tank Refills each**
  • Wide Wheelchair
    Wide Wheelchair
  • M-6 Tank Refills
    M-6 Tank Refills each **
  • Power Wheel Chair
    Power Wheel Chair
  • Otter Bath Chair
    Otter Bath Chair
  • Scooter large
    Scooter large (up to 450lbs cap)
  • Commode
    3-N-1 Commode
  • Scooter smal
    Scooter small (under 200lbs cap)
  • Nebulizer
    Nebulizer
  • Hoyer Lift
    Hoyer Lift
  • Shower Chair
    Shower Chair (On Wheels)
  • Hospital Bed
    Hospital Bed
  • Walker (4 wheel)
    Walker (4 wheel)
  • Concentrator
    Concentrator
  • Free Standing Trapeze
    Free Standing Trapeze
  • Conserving Device
    Conserving Device (Check Availability)

  • Method of Payment

  • We accept: Visa, Master Card, Discover, Amex
    You will be contacted for specific rental and payment information.