Request Equipment

Tell us what you need. That's the whole barrier to entry.

MEDQ Donation's request process is open — no income documentation, doctor's note, or referral required. Fill out the form and we'll reach out as soon as a match is available.

Request Form

What do you need?

Full name *

Phone *

Street address *

City *

ZIP code *

* Required field

What do you need?

Mobility (wheelchair, walker, cane)

Respiratory (oxygen, CPAP, nebulizer)

Hospital furniture (bed, table)

Daily living aids

Monitoring device

Supplies

Medical equipment (analyzers, lab supplies)

Describe what you need

How soon do you need it?

Pickup or delivery?

Anything else that would help us match you?

Submitting a request doesn't guarantee availability — we'll let you know either way, usually within a few business days.

Received

Thank you for your request.

We've added your request to our queue and will reach out by email or phone as soon as a matching item is available.