Medical Equipment Request Form

This form is intended only  for those who are unable to afford medical equipment or require it urgently. If you do not meet these criteria, please DO NOT  fill out this form.

All requests are subject to approval by the Admin, based on stringent verification processes. To qualify, you must provide: -

Proof of Need: A valid recommendation from a certified doctor. -

In Person Pick-Up: The equipment must be collected in person. No exceptions.

*We will cover travel expenses up to a maximum of  ₹200. Thank you for your understanding and cooperation.