Equipment Loaner Program Form

SMILE Mass has several pieces of equipment for families to borrow and take anywhere with them. Our current inventory includes: 10 floating beach wheelchairs, high performance running strollers, a Hoyer lift, a portable ramp and bath chair. Please download, print, fill out, & bring a copy of the waiver with you upon the day of pickup, Along with filling out the form below so we can get in contact with you as soon as possible!

Equipment Loaner Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • $100 for approximately 100 miles - within 2 hours of Sudbury. Additional fees will apply if distance is further.
  • If you could tell us where you are going, it will help us with pick-up/return planning
  • Date Format: MM slash DD slash YYYY
Special Thanks To Our Sponsors:
“SMILE Mass offered the Ocean Park, Maine community with a beach wheelchair in 2017. IT was used all summer long and people loved the freedom it gave them to see and experience the beach. This donation is a way for us to continue to say thanks. Your work is very important!”
Gerard Gosselin