---
title: Mobility Equipment Rental Form Template - Client Intake & Booking | Paperform
description: Professional mobility equipment rental form for medical supply businesses. Collect client details, equipment selection, rental periods, delivery needs, insurance verification, and process payments with rental agreements.
url: "https://paperform.co/templates/mobility-equipment-rental-form"
type: static
generatedAt: "2026-03-28T00:44:33.500Z"
---

[← Back to free form templates](/templates/)    ![Mobility Equipment Rental Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/mobility-equipment-rental-form.png)
    [Preview](https://_preview.paperform.co/ai-template/mobility-equipment-rental-form) [Use this template for free](/create?ai-template=mobility-equipment-rental-form)    [Intake Forms](/templates/category/intake-forms/)[Small Business Forms](/templates/category/small-business/) [Healthcare](/templates/industry/healthcare/)[Home Services](/templates/industry/home-services/) [Entrepreneur](/templates/role/entrepreneur/)[Small Business Owner](/templates/role/small-business-owner/)[Shop Owner](/templates/role/shop-owner/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
### Streamline Your Mobility Equipment Rental Business with Paperform

Running a mobility equipment rental business means juggling client intake, delivery logistics, insurance verification, and payment processing—all while ensuring customers get the devices they need quickly and safely. This **Mobility Equipment Rental Form** brings everything together in one professional, easy-to-use experience that works for wheelchair rentals, mobility scooters, walkers, crutches, and other assistive devices.

#### Built for Medical Equipment Providers and Home Healthcare Services

Whether you're a medical supply company, home healthcare provider, pharmacy with rental services, or specialized mobility equipment business, this template handles the complete rental workflow from first inquiry to signed agreement. Customers can select their equipment, choose rental periods, specify delivery needs, provide insurance details, and complete payment—all in a single form that looks professional and converts reliably.

The form uses **conditional logic** to show relevant questions based on equipment type and delivery preferences, keeping the experience streamlined while capturing all the details you need for fulfillment and compliance. Insurance fields adapt based on coverage type, and delivery options adjust pricing calculations automatically.

#### Accept Payments and eSignatures Without Extra Tools

With Paperform's built-in payment processing, you can collect rental deposits, full payments, or set up recurring charges for extended rentals directly through Stripe, PayPal, or Square. No need to invoice separately or chase down payments—customers complete the transaction as part of booking their equipment.

Once the form is submitted, use **[Papersign](https://papersign.com)** to automatically generate and send your rental agreement for eSignature. The signed contract is linked back to the original booking, creating a complete audit trail from inquiry to signed agreement to delivery—perfect for compliance and customer service follow-up.

#### Automate Your Rental Operations with Stepper

After a rental booking comes through, **[Stepper](https://stepper.io)** can automatically route the submission based on equipment availability, delivery zone, or insurance verification status. Send confirmations to customers, create delivery tickets in your project management system, update inventory in your database, and notify your warehouse or delivery team—all without manual data entry.

For businesses managing multiple locations or franchise operations, Stepper keeps everyone in sync while letting you maintain oversight of all rental activity from a central dashboard.

#### Perfect for SMBs in Healthcare and Home Services

This template is designed for small and medium businesses that need a professional, compliant intake process but don't have the resources for custom software development. Medical equipment providers, home healthcare agencies, pharmacies, physical therapy clinics with rental programs, and elder care services will find everything they need to replace PDFs, email chains, and phone tag with a single smooth workflow.

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