Request Equipment

Whether you are a healthcare provider seeking equipment for your patients, a member of a mission team on a global health initiative, or an individual in need of assistance for yourself or a loved one, our organization is here to help. Our streamlined application process is accessible below, and allows anyone to request essential adaptive equipment to improve patient care, enhance independence, and promote a better quality of life.

We invite all qualified individuals and organizations to participate in this valuable program.

Equipment Request Form

All individuals are welcome to request adaptive equipment from us through the following form. 

Examples of Adaptive Equipment

Mobility Aids

Devices to help with independence in mobility, including:​

  • Walkers

  • Canes

  • Wheelchairs

  • Crutches

Home Safety

Devices to make the home more safe, including:​

  • Grab bars

  • Nightlights

  • Shower seats

  • Non-slip mats