Cure SMA Teen & Adult Support Package Request Form

 

Please fill out the form below to request a Cure SMA Support Package. Upon submitting the request form below we will ship out your support package in the order it was received. Due to the high demand for this new program we have run out inventory on a few of the items so we have reordered everything and are waiting for the items to arrive to be able to get the rest of the packages sent out sometime in January or early February.  Please email supportpackage@curesma.org with any questions.  Also, please note we are unable to ship to PO boxes.

Eligibility Criteria:
Must be diagnosed with SMA and be 13 years of age or older. Must live within the US.

  Contact Information:

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Date of Birth:

 


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Question - Required - Diagnosis Date




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