ALS Ice Bucket Challenge Progress

 

Medical Equipment Loan Closet Program

 Vegas 2019 6

The ALS Association Nevada Chapter offers a program to assist those living with ALS to obtain needed medical equipment and assistive technology. This includes:

Please contact our office or your Care Services Coordinator if you are a person with ALS seeking a medical equipment loan.
 
Do you have medical equipment that you would like to donate to our chapter? Please submit the form below or contact our office.
 
*1.

*2.
Question - Required - Please describe the condition of the equipment item(s) you would like to donate.
Please make between 1 and 4 selections from the choices below.

*3.
Question - Required - Please select the approximate age of the equipment item(s) you would like to donate.
Please make at least 1 selection from the choices below.

*4.

(Maximum response 255 chars, approx. 5 rows of text)

5. Please list your name and contact information so we can reach you about the equipment you'd like to donate.

*

Name:

 

 

   

*

 

 

 

City/State/ZIP:

 

    

*

 

 

 

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