Vitrectomy Essential Package

The Essential Package Equipment

With the OWL Leasing Essential Package, you'll be on the road to recovery in no time. This two piece rental package offers you the Premier Sleep System and the Premier Seated Support. The exceptional comfort and ergonomic design of each of these items team up to help keep you in compliance.

Included In The Essential Package:

Premier Sleep System
Premier Seated Support
3-Pad Face Cushion (1)
Crescent Face Cushion (2)
Flannel Covers
Sternum Pad
Adjustable Mirror
Travel Block
Written Instructions

Rental Period	Cost
1st Week*	$236
Each Additional Week	$177
Daily	$38

*One-week minimum, fuel surcharge may apply

This package has an additional $150 shipping charge when shipping to the following states:

Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington & Wyoming.

Standard Ground Shipping is FREE on all other orders outside of the states listed above.
Overnight or Next Day shipping services are available for an additional fee. Please call a Personal Care Consultant to review the prices associated with your state and/or expedited shipping request.

Online Reservation

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Please fill out the form below. You will be contacted within 24 business hours by one of our Patient Service Representatives to complete your order for vitrectomy surgery recovery equipment.

Patient's First Name*

Patient's Last Name*

Contact Name (if not patient)

Primary Phone*

Alternate Phone

Delivery Address*

Street Address Address Line 2 City State ZIP Code

Billing Address*

Same as Delivery Address

Street Address Address Line 2 City State ZIP Code

Date of Birth (mm/dd/yyyy)

Date of Surgery (mm/dd/yyyy)*

Surgeon

Office/Practice Name

Expected Length of Rental

Package

Terms & Conditions*

I agree to the Terms & Conditions.

• McFee Medical Technologies/OWL Leasing, Inc. no longer offer a refund once the equipment has been shipped. Any cancellations made prior to shipping will not be charged.

• It is my responsibility to report to McFee Medical Technologies/OWL Leasing, Inc. any damage beyond normal wear and tear or missing items immediately upon receipt of shipment to avoid any lost item charges.

• It is my responsibility to ensure that McFee Medical Technologies/OWL Leasing, Inc. receives all of the contracted rental equipment after the agreed upon rental period or I will be charged the rental fee for each day the equipment is not returned (this means I must notify McFee Medical Technologies/OWL Leasing the DAY I want my rental to be ended). McFee Medical Technologies/OWL Leasing, Inc. recommends that you contact the shipping company identified on the yellow equipment return instruction card located in your rental equipment boxes prior to your rental completion date for timely arrangements and policy compliance.

• A restocking fee of $100.00 per box will be charged to the credit card on file or billed to the patient for any Non-Smoking equipment returned with the odor of smoke.

• If I do not return the equipment to McFee Medical Technologies/OWL Leasing, Inc. fully assembled and in good condition, allowing for normal wear and tear, I will be charged a restocking fee accordingly.

• The credit card I provided at the time of rental will be used to secure additional charges incurred due to late return or damaged equipment.

• McFee Medical Technologies/OWL Leasing, Inc. makes no medical representations regarding the use of the equipment.

• McFee Medical Technologies/OWL Leasing, Inc. is not responsible for any medical condition arising or resulting from any medical treatment, including without limitation; eye surgery rendered to me by a physician or qualified healthcare provider.

• McFee Medical Technologies/OWL Leasing, Inc. is not responsible for any injuries/damages resulting from use of the equipment in a manner not intended.

• Submitting this Online Reservation Form signifies acceptance of the Rental Terms and Conditions. I understand and authorize that my credit card will be charged before any commercial (or other) insurance claim can be filed per this agreement. The charges may also be listed under the following names: Marketplus Software, McFee Medical Technologies, or OWL Leasing.

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