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Equipment and Warranty Notification
Every product sold or rented by our company carries either a 1, 2, 3 years Manufacturer’s warranty. Please
refer to your equipment manufacturer guide for the details pertaining to your prescribed therapy equipment.

Pulmonary Solutions will notify all Medicare beneficiaries of the warranty coverage, and we will honor all
warranties under applicable law.

Pulmonary Solutions 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 (standard #6).

Pulmonary Solutions will maintain and replace at no charge or repair directly, or through a service contract
with another company, Medicare- covered items we have rented to you (standard #14).

Pulmonary Solutions will accept returns of substandard (less than full quality for the particular item) or
unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from
beneficiaries (standard #15).

I have been instructed and understand the equipment and warranty coverage on the product I have
received.

______________________  _________
Beneficiary Signature   Date

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