Forms

Patient Forms

Please download and complete an order form below
Fax to (925) 307-5395 or email to info@wecareforabetteru.com

DME PRESCRIPTION ORDER FORM
RENTAL REQUEST FORM
BREAST PUMP REFERRAL FORM
COMPRESSION GARMENTS
INCONTINENCE SUPPLIES

MEDICAL EQUIPMENT RENTALS

Here at WeCare for AbetterU, we offer a wide variety of durable and high-quality rental medical equipment, such as hospital bed rentals, mobility scooter rentals, electric wheelchair rentals, patient lift rentals, and much more. We offer same day or next day delivery and set-up on all our available equipment. We make sure all our equipment is thoroughly cleaned and sanitized prior to your delivery!

“Whether you need to rent for the week, a month, a year, or longer, our dedicated team is ready to help.”

Submit Rental Request

Hospice intake form

Hospice Intake Form