1. I, an employee of Mary Free Bed Rehabilitation Hospital, hereby authorize Mary Free Bed to deduct the amount specified above from my paycheck for the specified uniforms for the number of pay periods listed. Deduction begins with the first pay of the month following purchase date.

2. If this is an annual deduction, I, an employee of Mary Free Bed Rehabilitation, hereby authorizeMary Free Bed to deduct the specified amount, per pay period. Deduction begins with the first pay of the month following purchase date.

3. I also further authorize Mary Free Bed, upon termination of employment for any reason, to withhold payment of any expense reimbursement, PTO pay or any other payments to which I may be otherwise entitled, up to the amount of any unpaid principal under this note.

4. I acknowledge and declare

  • This authorization is given knowingly, voluntarily and without intimidation or threat of loss of employment, and the deductions made hereunder are for my benefit.
  • Neither this authorization, nor any loan made in connection with this authorization, confers any right to continuing employment or any other employment rights.
  • In the event that the total amount is not deducted or that my final check does not cover the full amount owed, I understand that I am responsible for the remaining balance.
  • The giving of this authorization does not limit or restrict Mary Free Bed’s right to obtain repayment in part or in full through other means.


Masks or Face Coverings ARE MANDATORY when shopping or picking up orders.

We are cleaning and wiping down frequently used surfaces throughout the day to help keep our employees and customers safe. If you need to place an order, you can also call one of our stores, email us at or place an order on this website.

We will process all orders as quickly as we can, but it may be outside our normal delivery time. Covid has caused issues with many of the companies in our supply chain. We appreciate your patience during this trying time.