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Communication Equipment Check Out Form

This form assigns primary responsibility for the National Association of Chronic Disease Directors (NACDD) equipment to the borrower. The borrower will be responsible for taking the necessary precautions to protect the equipment and to store it in a manner that provides adequate protection when it is not in use, thus not subjecting the equipment to possible theft or damage. If it is determined that loss or damage is a result of negligence, the borrower may be held financially responsible for the repair or replacement of the equipment.

1. The borrower will be responsible for return of the equipment in like condition as received.

2. Equipment cannot be loaned or transferred to a third party.

3. The borrower cannot modify the equipment in any way without written approval of NACDD's Communications department.

4.  The borrower will make the equipment available at any time as requested by NACDD.

By submitting the NACDD Communications equipment check out form, you have read the above information and agree to the terms and conditions herein contained.

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National Association of Chronic Disease Directors
2200 Century Parkway, Suite 250
Atlanta, GA 30345
Phone (770) 458-7400
Fax (770) 458-7401


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