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Terms & Conditions
I acknowledge receipt of a complete BiliTouch™ Phototherapy system. I am responsible for replacing any components that are damaged, lost, stolen, or otherwise unreturnable. The retail value of this unit is $3,000 and is property of Bencor Medical. (800) 620-6327
Patient Acknowledgement
- I herby authorize Bencor Medical (herein referred to as "Provider") to provide the prescribed equipment, and understand that the Provider is an independent company and not part of any medical practice, hospital, or other company.
- I certify that the information provided is true and correct.
- I have been instructed on the proper and safe use of this equipment.
- I have received training on proper use of equipment and payment policies.
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