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Knee Walker Rentals of Georgia, Inc.

Other medical equipment companies promise-We DELIVER.SHIP since 2005!

About Us

Our company has been built on the belief that our customers' safety, mobility and recovery needs are of the utmost importance to them and their physical and emotional wellbeing. We recognize that when a person suffers from a health

 setback, and must be non-weight bearing for a number of weeks and/or months, their livelihood, personally, professionally, and financially, can suffer as well. This is especially the case during the rise of the COVID-19 pandemic when/where so much depends on our good health. 

Therefore, our entire team is committed to the goal of IMMEDIATELY addressing/meeting your medical needs through the dispencing of disposable and/or surgical masks and the mobility assistance afforded by a knee walker, electric scooter/manual wheelchair or rollator purchase and/or rental. Our team are among the most empathetic, motivated and talented in the industry and we test/prove it daily. We can/will professionally educate you with the benefits and safe usage of the knee walkers, electric scooters, manual wheelchairs, and rollators by personally delivering/picking up within 90 miles of downtown Atlanta, same day service, within hours, NOT DAYS/WEEKS, with a modest one-time fuel surcharge for pickup & delivery, not included in the rental charge. Our masks will be delivered and/or shipped the same day depending on preference. For 16+ years, these are but a few of the reasons why we are most trusted and being used daily by a number of local orthopedic and podiatry doctors/groups, ERs and hospitals within the metro Atlanta area such as Piedmont, Emory, CHOA, Dekalb Medical, Wellstar and Northside Hospitals, physician groups, such as Emory, Resurgens, Orthoatlanta, Southern, Pinnacle Orthopedics, Village Podiatry Centers, Foot & Ankle Centers, Workers Compensation groups and individual orthopedists, podiatrists, and doctors' offices.

As a result of our TOTAL commitment to providing YOU the very best quality care, with same day service, a very high percentage of our referrals come from various orthopedic physicians and "Word or mouth" (Patients and satisfied customer referrals).

COME JOIN US! It would be our pleasure to put our empathetic, yet extensive experience to work for you in your time of medical need.

We would welcome the opportunity to earn your trust and deliver you the same great service that we've grown accustomed to providing to our clients for many years. It is our pleasure to serve you TODAY!

Thank You!


Knee Walker Rentals of Georgia, Inc.

Customer Service Dept.

678-858-5922


PROUD DME SUPPLIERS for: 


PowerPoint presentation

*Please click on thePowerPoint presentation

below regarding us and related medical/product information.

**Please click on the Knee Walker Rental Contract or Vive Purchase Agreement to upload, read, review, print and sign. 

 VIVE SCOOTER PURCHASE AGREEMENT

VIVE ELECTRIC SCOOTER PURCHASE AGREEMENT $845

Knee Walker Rentals of Georgia, Inc.

1251 Julie Court

Riverdale, Ga. 30296

678-858-5922 OFC 888-789-4160 FAX

[email protected]

http://www.kneewalkerrentalsofga.com/

PARTIES INVOLVED IN THIS PURCHASE AGREEMENT

SELLER/DISTRIBUTOR: The distributor selling the DME property (Vive scooter) Knee Walker Rentals of Georgia, Inc, dba DME of Georgia, Inc. herein referred to as “Seller”.

PURCHASER: The individual or company executing this purchase agreement and making payment to complete the purchase, herein referred to as "Purchaser".

PURCHASE AGREEMENT TERMS AND CONDITIONS

PURCHASE TERMS: All Vive scooters sold are new, whether delivered in or out of box, based on “Purchaser” preference. The sales date of this agreement shall be the date the new Vive scooter is delivered to the "Purchaser" premises by “Seller.” and payment is made and received. Neither the sale or the sales date of this purchase agreement can/shall be canceled or rescinded by either party after 12 hours of the delivery time and date. If the “Purchaser” contacts the “Seller” informing that the purchased Vive scooter is needing to be returned within 12 hours of the delivery time and date to “Seller”, the “Seller” will make the pickup of the returned Vive scooter. If the return is due to undesired expectations, improper fit, safety and/or manufacturer’s defect, the “Seller” will refund the amount paid, minus the delivery fee (Avg. $75-100), within 24 hours of Vive scooter return. A warranty brochure from the manufacturer, Vive Health, accompanies all deliveries of the new Vive scooter and is provided to the “Purchaser” on delivery.

INSPECTION: "Purchaser" acknowledges that their new Vive scooter was inspected and examined by "Puchaser" prior to acceptance and signing the Purchase Agreement. “Purchaser” also acknowledges their Vive scooter was found to be in undamaged and in good working condition at the delivery time and date. "Purchaser" further acknowledges that the proper safe usage and breakdown of their Vive scooter was educated and demonstrated to the “Purchaser” on the delivery appointment and the “Purchaser demonstrated their full understanding of the proper setup, breakdown and usage of their new Vive scooter. "Purchaser" further acknowledges their duty to inspect the Vive scooter prior to use and notify “Seller” of any defects. If within 12 hours of the delivery time and date, any defects are found or in a state of disrepair "Purchaser" will immediately discontinue usage and contact “Seller” for

further instructions. “Seller” will promptly make arrangements for a return of the Vive scooter to the “Purchaser”. If within 12 hours of the delivery time and date, “Purchaser” agrees to use reasonable effort to either replace the Vive scooter with similar property in good working condition or arrange a refund as soon as possible. IMPORTANT: PLEASE FULLY INSPECT YOUR VIVE SCOOTER IMMEDIATELY UPON RECEIPT OF THE ITEM AND NOTIFY SELLER OF ANY DAMAGE OR DEFECTS WITHIN 12 HOURS OF THE DELIVERY TIME/DATE. ANY DAMAGE SUSTAINED AFTER THE 12 HOUR DELIVERY TIME/DATE WILL BE REPORTED TO THE MANUFACTURER, VIVE HEALTH (239) 220-5772, FOR INSTRUCTIONS AND IF NEEDED, WARRANTY WORK.

BODILY INJURY AND PROPERTY DAMAGE RESPONSIBILITY: “Seller” provides nor assumes any BODILY INJURY or PROPERTY DAMAGE LIABILITY INSURANCE or coverage to “Purchaser” or any other operator or user for bodily injury or property damage to/from the Vive scooter. "Purchaser" agrees to defend, indemnify and hold “Seller” harmless from any claims, liabilities, costs and expenses arising from the "Purchasers” use, operation or possession of the Vive scooter.

PAYMENT: "Purchaser" agrees that payment in full ($845.00)

will be paid in cash or check, money order/official check made payable to

“Seller.” upon execution of this Purchase Agreement. Unless stipulated otherwise, “Purchaser” acknowledges that a shipping/delivery fee (Avg. $75-100), is included in the $845 purchase price, as deemed applicable, based on distance of the delivery. Above rates do not include any applicable taxes.

TITLE TO PURCHASED PROPERTY: After 12 hours of the delivery time and date, title to the Purchased Property, the new Vive scooter, will at all times remain with the “Purchaser” unless there is a future sale of the Vive scooter to another person or entity.

COLLECTION COSTS: In the event that “Seller” must resort to litigation to obtain Sale charges, Returned check charges or any and all other monies due from "Purchaser", "Purchaser" agrees to pay attorney's fees, court costs and other expenses which are incurred by “Seller” as a result, directly or indirectly, of “Seller’s” entering into this Purchase Agreement with "Purchaser".

SEVERABILITY: The provisions of this Purchase Agreement shall be severable so that the invalidity, unenforceability or waiver of any of the provisions shall not affect the remaining provisions.

MINIMUM AGE: The minimum age to execute this Purchase Agreement is 18 years of age, proven with Presentation and Photographing of a valid, current state identification or passport.

CANCELLED RESERVATIONS: "Knee Walker Rentals of Georgia, Inc dba DME of Georgia, Inc., aka “Seller “Seller” will not be held responsible for cancellation of sale due to depletion of inventory beyond “Seller’s” control. This Purchase Agreement may be canceled at any time by either party prior to the physical shipment/delivery of the new Vive scooter. However, this Purchase Agreement is binding and may not be canceled for any reason 12 hours after order is delivered, received and full payment is made and accepted by “Seller”.” By signing this Purchase Agreement, “Purchaser” confirms either having read the Purchasing Agreement online (http://www.kneewalkerrentalsofga.com/)and agree to the terms of this Purchase Agreement, a legal sales document or was offered the opportunity to read and/or copy the full Purchase Agreement upon delivery of their new Vive scooter. “Purchaser” agree to contact “Seller” immediately for any defects, repairs, etc., within 12 hours of delivery time and date. “Purchaser” has read, reviewed and agreed to the full terms of this Purchase Agreement, as indicated by signing the following final page of this Purchase Agreement. IF APPLICABLE, “Purchaser” may use a copy of this agreement for possible reimbursement through their insurance company. I acknowledge that “Seller” is not in-network with any insurance carrier/coverage and will not file the Purchase Agreement to the “Purchaser’s” private insurance company, Medicare and/or Medicaid. If desired, “Purchaser” acknowledges that ANY filing with their personal insurance, Medicare and/or Medicaid is their full responsibility.


KNEE WALKER RENTALS OF GEORGIA, INC. PURCHASE AGREEMENT/APPROVAL FORM


PURCHASER’S NAME:-_____________________________________________

PURCHASER’S SIGNATURE /APPROVAL OF PURCHASE AGREEMENT TERMS*__________________________________________________________

: *BY SIGNING ABOVE, I AGREE TO THE PURCHASE AGREEMENT TERMS AND MY PHOTO AND DRIVER’S LICENSE COPIED AND/OR PHOTOGRAPHED)

DATE OF BIRTH: ___________________________________________________

ADDRESS:________________________________________________________

CITY: STATE: ZIP:__________________________________________________

HEIGHT: ______WEIGHT: ______LBS INJURY: R / L BOTH GENDER: FEMALE / MALE

DRIVER’S LICENSE/ID #: ______________STATE: ___________DATE OF ISSUE:______________________

DRIVER’S LICENSE/ID DATE OF EXPIRATION:_________________________    EMAIL ADDRESS:__________________________________________________

BEST PHONE#: ________________CELL PHONE/ALT:___________________

DATE(S) OF ELECTRIC SCOOTER PURCHASE: _________________________ HCPCS CODE: K0003/1230

ANTICIPATED USAGE PERIOD NEEDED (WEEKS): 99 WEEKS=PURCHASE*

MOBILITY BRAND/MODEL BEING PURCHASED:________________________

DEPOSIT/AMOUNT PAID: $____/ $_________PAYMENT TYPE: _____________ TRANS#_________________________________________________________

***ONLY FOR CLIENTS SEEKING REIMBURSEMENT FROM INSURANCE***

INSURANCE COMPANY:___________PRIOR AUTHORIZATION NEEDED: Y / N

ID/MEMBER #:_____________GRP #:______________PHONE #:____________

MEDICARE: Y / N HICN#_____________   EFF. DATES: A/B:

INFORMATION BELOW TO BE ENTERED BY PHYSICIAN, PA, PHYSICIAN’S EMPLOYEE

PRIMARY DIAGNOSIS / APPLICABLE ICD-10 CODE(S):___________________

ESTIMATED LENGTH OF NEED (# IN WEEKS/MONTHS)* 99 WEEKS=PURCHASE*

PROCEDURE CODE(S):______________________________________________

PROGNOSIS/NOTES: _______________________________________________

PHYSICIAN’S CERTIFICATION: AFTER A COMPLETE, COMPREHENSIVE EVALUATION OF THIS PATIENT, I CERTIFY THE DURABLE MEDICAL EQUIPMENT/SUPPLIES LISTED ABOVE IS MEDICALLY NECESSARY, BASED ON THE APPLICABLE MEDICAL ICD-10 CODES EXPRESSED ABOVE.

PHYSICIAN’S OR PA-C NAME: ____________________NPI#:_______________

ADDRESS: __________________________GRP:_________________________

CITY, STATE, ZIP: _____________________PHONE:  _____________________  FAX:_____________________________________________________________

PHYSICIAN’S SIGNATURE:___________________________________________

PLEASE SIGN, FILL IN APPLICABLE ICD-10 CODES AND FAX TO KNEE WALKER RENTALS OF GEORGIA, INC. 

 1-888-789-4160 FAX 678-858-5922 OFFICE

 FOUR WEEK KNEE WALKER RENTAL CONTRACT $140

Knee Walker Rentals of Georgia

1251 Julie Court

Riverdale, Ga. 30296

678-858-5922 OFC 888-789-4160 FAX

[email protected]

http://www.kneewalkerrentalsofga.com/

Parties to the Lessee Request:

LESSOR: The Lessor of The Rented Property herein called “Knee Walker Rentals of Georgia, Inc,”

LESSEE: The individual or company executing this agreement herein called "Customer".

Lease Agreement

LEASE TERMS: The start date of this lease shall be the date the item is delivered to the "Customer" premises by Knee Walker Rentals of Georgia”. The end date of this lease shall be the date the item is returned to Knee Walker Rentals of Georgia.

INSPECTION: "Customer" acknowledges that Rented Property was inspected and examined by "Customer" prior to acceptance and such Rented Property was found to be in good working condition at that time and "Customer" understands the proper use of said Rented Property.

"Customer" further acknowledges his duty to inspect the Rented Property prior to use and notify Lessor of any defects. If any defects are found, "Customer" will immediately contact Lessor for further instructions. PLEASE INSPECT YOUR TURNING LEG CADDY or KNEE WALKER IMMEDIATELY UPON RECEIPT OF THE ITEM AND NOTIFY LESSOR OF ANY DAMAGE OR DEFECTS.

MALFUNCTIONING RENTED PROPERTY: "Customer" agrees that in the event that any Rented Property becomes unsafe or in a state of disrepair, "Customer" will immediately discontinue the use thereof and promptly return it to the Lessor at Lessor's place of business and notify Lessor of its condition. Lessor agrees to use reasonable effort to replace the Rented Property with similar property in good working condition as soon as possible, but Lessor does not guarantee to do so.However, Lessor may refund monies remaining, if any, on the unused portion of the contract. Lessor shall not be liable in any event for any loss, delay or damage of any kind or character whatever resulting from defects in or inefficiency of the Rented Property or accidental breakage hereof.

DAMAGE TO THE RENTED PROPERTY: "Customer" is responsible for and agrees to pay Knee Walker Rentals of Georgia the fair market value for replacing the Rented Property ($385-$465) and or repairing damage to the Rented Property, including: loss of use, claim administration fees, diminishment of value, and cost incurred by Lessor to recover the Rented Property and to establish damage, regardless of fault or negligence of the Lessee or any person, and regardless if damages are the result of an act of God. For purposes of the Agreement, the fair market value for the cost of replacing Knee Walker Rentals of Georgia’s Rented Property shall be "Purchase Price".Fair market value for any repairs to the Rented Property shall be retail cost of parts and $30.00 per hour for labor. At no time will the total cost of rental and repairs exceed the current "Purchase Price" of the item. All repairs to the Rented Property shall be retail cost of parts and $30.00 per hour for labor. At no time will the total cost of rental and repairs exceed the current "Purchase Price" of the item.

BODILY INJURY AND PROPERTY DAMAGE RESPONSIBILITY: Knee Walker Rentals of Georgia provides no BODILY INJURY or PROPERTY DAMAGE LIABILITY INSURANCE or coverage to Lessee or any other operator or user for bodily injury or property damage to "Customer", operator, user or any third party. Customers insurance applies, "Customer" represents and warrants that they have and will maintain in force during the term of this rental agreement, BODILY INJURY and PROPERTY DAMAGE LIABILITY INSURANCE for "Customer" or any other operator of Knee Walker Rentals of Georgia’s Rented Property. "Customer" agrees to defend, indemnify and hold Knee Walker Rentals of Georgia harmless from any claims, liabilities, costs and expenses arising from the "Customers” use, operation or

possession of the Rented Property.

RETURN OF RENTAL PROPERTY: This lease continues until the leased property is returned to Knee Walker Rentals of Georgia. FAILURE TO RETURN RENTED PROPERTY: Failure to return the rented property shall be deemed continuation of this lease agreement.

PAYMENT: "Customer" agrees that payment in full for a four week minimum term ($140.00) will be paid in cash(On weekends), check or money order/official check made payable to “Kavsab, Inc.” upon execution of this lease. Unless specified in writing, a deposit on all leases will be made payable in the terms above for a minimum of $140.00 (Example: Four week rental of $140 plus $140 deposit=$320 payable at lease execution*). *Lessee also agrees to pay shipping/delivery costs, as applicable. Lessee further agrees that payment for each additional week must be paid/received by Knee Walker Rentals of Georgia by the start of each week beginning with the third week, until the item is returned and received by Knee Walker Rentals of Georgia. Upon receipt and inspection of the returned item, this lease will be considered terminated upon the return date. Knee Walker Rentals of Georgia will promptly settle the account accordingly, including refunding any monies due "Customer". All returned checks must be paid in cash for face amount, plus $35.

TITLE TO RENTED PROPERTY: Title to the Rented Property at all times shall remain with Knee Walker Rentals of Georgia unless there is an initial written establishment, acceptance and agreement of purchase versus rental-to-ownership initially AND upon delivery, when the agreed upon purchase price is paid in full i.e. A RENTAL STARTS AND ENDS AS A RENTAL. A PURCHASE STARTS AND ENDS AS A PURCHASE. No rent-to-own of the rental products.

"Customer" agrees to give Knee Walker Rentals of Georgia immediate notice of any levy attempted upon the Rental Property of any seizure of Rented Property for any reason and Lessee will indemnify Knee Walker Rentals of Georgia against all loss and damages caused by any such actions including court costs, attorney's fees and other expenses which are incurred by Knee Walker Rentals of Georgia in defense thereof.

COLLECTION COSTS: In the event that Lessor must resort to litigation to obtain Rental Charges, reimbursement for damages to or loss of Rented Property enforcement of Lessor's rights under this contract, or any and all other monies due from "Customer", "Customer" agrees to pay attorney's fees, court costs and other expenses which are incurred by Knee Walker Rentals of Georgia as a result, directly or indirectly, of Knee Walker Rentals of Georgia’s entering into this Rental contract with "Customer".

SEVERABILITY: The provisions of the Contract shall be severable so that the invalidity, unenforceability or waiver of any of the provisions shall not affect the remaining provisions.

THEFT: In the event of theft, "Customer" shall be responsible for the full purchase price.

MINIMUM AGE: The minimum age for Knee Walker Rentals is 18 years, proved with presentation and photographing of a valid, current state-issued identification and/or passport.

CANCELLED RESERVATIONS: Knee Walker Rentals of Georgia will not be held responsible for cancellation of Rental Property due to depletion of inventory beyond Knee Walker Rentals of Georgia’s control. This agreement may be canceled at anytime by either party prior to the physical shipment/delivery of the item. However, This Agreement is binding and may not be canceled 12 hours after order is received, delivery is made and payment accepted. Fuel surcharge will still apply if canceled within 12 hours after delivery. 

RENTAL RATES AND CONDITION: The first four weeks rental rate shall be paid in advance and shall be nonrefundable upon shipment/delivery of the rented property from the premises of Knee Walker Rentals of Georgia.

Rental Rates: (*Not including $140 refundable deposit)

First Four Weeks (Minimum Rental Period) $140.00

3&4th Week $35.00 extra

6th Week $35.00 extra

7th Week $35.00 extra

8th Week (2 Month) $280.00

9th Week $35.00

10th Week through End of Term Shall Be $35.00 per Week

Knee Walker Rentals of Georgia pickup/delivery service is subject to a fuel surcharge depending on delivery/pickup location.

"Customer" shall be responsible for contacting Knee Walker Rentals of Georgia to arrange pickup/delivery to/from their location. Above rates do not include any applicable taxes.

By initialing this box, I confirm that I have read and agree to the terms of this Lessee Agreement, a legal rental document. I agree to being photographed by Knee Walker Rentals of Georgia. In all cases, I agree to contact Knee Walker Rentals of Georgia immediately for any defects, repairs, etc. I’ve read and completed the following page and signed this lessee agreement. IF APPLICABLE, I may use a copy of this agreement for reimbursement through my insurance company. I acknowledge that Knee Walker Rentals of Georgia is not in-network with my insurance carrier and will not file the lessee agreement to my private insurance company, Medicare and/or Medicaid. I acknowledge that ANY filing with my private insurance company, Medicare and/or Medicaid is my full responsibility. ______________________________


KNEE WALKER RENTALS OF GEORGIA, INC. RENTAL AGREEMENT/APPROVAL FORM


RENTER’S NAME: _________________________________________________

RENTER’S SIGNATURE/APPROVAL OF RENTAL AGREEMENT:_____________________________________________________

*BY SIGNING ABOVE, I AGREE TO THE RENTAL TERMS BELOW AND MY PHOTO AND DRIVER’S LICENSE COPIED AND/OR PHOTOGRAPHED. I AGREE IT IS MY RESPONSIBILITY TO FILE FOR INSURANCE REIMBURSEMENT, IF DESIRED. I ALSO AGREE TO RETURNING THE RENTAL EQUIPMENT CLEAN, ON TIME AND IN OPTIMAL WORKING CONDITION OR I WILL BE HELD RESPONSIBLE FOR UP TO THE FULL REPLACEMENT COST OF THE RENTAL EQUIPMENT BASED ON BRAND/MODEL. ($285-435)

DATE OF BIRTH:___________________________________________________

ADDRESS:________________________________________________________

CITY: STATE: ZIP:__________________________________________________

HEIGHT: _______WEIGHT:______LBS INJURY: R / L BOTH GENDER: FEMALE / MALE

DRIVER’S LICENSE/ID #:_______________STATE:___________________DATE OF ISSUE:_________________________________________________________

DRIVER’S LICENSE DATE OF EXPIRATION:_____________________________ EMAIL ADDRESS:__________________________________________________

HOME PHONE: _______________CELL PHONE/ALT:______________________

DATE OF KNEE WALKER/WHEELCHAIR/ROLLATOR RENTAL:_____________

ANTICIPATED RENTAL PERIOD NEEDED (WEEKS):________ WEEKS 

 HCPCS CODE: E0118-RR

KNEE WALKER BRAND/MODEL BEING RENTED:________________________

DEP/AMOUNT PAID: $0/$______BANK NAME:___________________________ TRANS ID#________________________________________________________

***ONLY FOR CLIENTS SEEKING INSURANCE REIMBURSEMENT***

INSURANCE COMPANY:___________PRIOR AUTHORIZATION NEEDED: Y / N

ID/MEMBER #:______________ GRP #:___________PHONE #:_____________

MEDICARE: Y / N HICN#_________________   EFF. DATES: A/B:___________

INFORMATION BELOW TO BE ENTERED BY PHYSICIAN OR PHYSICIAN’S ASSISTANT

PRIMARY DIAGNOSIS / ICD-10 CODE(S):_______________________________

ESTIMATED LENGTH OF NEED (# IN WEEKS/MONTHS):____________WEEKS

PROCEDURE CODE(S):______________________________________________

PROGNOSIS/NOTES:________________________________________________

PHYSICIAN’S OR PA’S NAME:_____________________NPI#:_______________

ADDRESS:______________________GRP:______________________________

CITY, STATE, ZIP:___________________________________________________

PHONE:___________________________FAX:____________________________

PHYSICIAN’S/PA-C SIGNATURE:______________________________________

PLEASE SIGN, FILL IN APPLICABLE ICD-10 CODES AND FAX

TO KNEE WALKER RENTALS OF GEORGIA, INC.

1-888-789-4160 FAX 678-858-5922 OFFICE



Please call us immediately 678-858-5922

if you are going to be scheduling an immediate appointment with us. 

Otherwise, once your paperwork is completed, please call 678-858-5922 to schedule/ from 0a-9p, 7 days a week. You can also leave a message and/or fax to: 

                     1-888-789-4160 or email us at:   

                [email protected] 

Contact info:

Fax Number 1-888-789-4160

Email address:[email protected]

Our normal hours are:

Mon, Tues, Thurs, Fri: 9AM - 9PM

Wed 9AM-5PM

Sat: 9AM - 9PM

Sun: 9AM-9PM