Donate Equipment

INFORMATION

Name / Surname  *

Address direccionnacimiento

City *

Province direccionnacimiento

Country

Tel *

E-mail *

Convenient day *

Convenient time

DONATION DESCRIPTION

Please check (x) the item you have for donation:

CANE

WALKER

CRUTCHES

CANADIAN CRUTCHES

COMMODE CHAIR

CUSHION

HOYER LIFT

REHAB EQUIPMENT

MANUAL WHEELCHAIR

POWER WHEELCHAIR

HEARING AID

WHITE CANE

BRAILLE MACHINE

COMPUTER

LAPTOP

TABLET

CELLULAR

OTHER

Comment:

—Yes, I would like donate a mobility / rehab and assistive device.

We’d love to hear from you! Feel free to get in touch with any questions or comments, or to discover how you can join Puri Napaq - Mobility without borders in transforming the lives of People with disabilities and their families around the world.