UAB Home Infusion Therapy 601 19 th Street South, Suite Q440E 4 th Floor Quarterback Tower Birmingham, AL 35249
EQUIPMENT WARRANTY INFORMATION FORM
Every product sold or rented by our company carries a 1-year manufacturer’ s warranty. UAB Home Infusion Therapy will notify all Medicare beneficiaries of the warranty coverage, and we will honor all warranties under applicable law.
UAB Home Infusion Therapy will repair or replace, free of charge, Medicare-covered equipment that is under warranty. In addition, an owner’ s manual with warranty information will be provided to beneficiaries for all durable medical equipment where this manual is available.
I have been instructed and understand the warranty coverage on the product I have received.
Beneficiary’ s Signature Date
26 UAB Home Infusion Therapy