Request Form – CARE PROJECT

CARE request

  • Please let us know if voice mail or a text would be better.
  • Would you like your name to be added to an email listing to receive Featured Items for the Month, Upcoming Events, or updates on the CARE Project and other Easter Seals Central Alabama Programs?
  • In which Alabama county does the recipient reside?
  • Only needed if requested item may have size limitations.
  • If the item you are requesting is not in stock, do you want to be placed on a waiting list?
  • If you have been referred by another agency, Hospital/Doctor’s Office or other Health Organization, what is the name and phone number for that organization so that we may properly fill your request?
  • Please be patient. A member of the CARE PROJECT will reply to your request as soon as possible. If this is an emergency, contact your local Durable Medical Equipment Supplier. CARE is not an emergency program. Staff and time are limited and requests may take time depending upon availability. Thank you!