Medical Shipment Feedback Form

Medical Shipment Feedback Form
MedWish International ships medical humanitarian aid around the world and sometimes it can be difficult to learn the impact of these shipments. Thank you for helping us collect feedback and stories about our work!

To view and example of how we use recipient feedback, please see below:
Your Name*

First NameLast Name
Email *
example@example.com
Hospital/Clinic/Mission *
Country*
How have the supplies in this box/shipment impacted you and/or your patients?
Photos

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Who packed your box? (Noted under the QR code)
Terms and Conditions:

By submitting this form, you authorize and confirm that MedWish International has full permission for the use of the names, photographs (still or video), and information provided in this form, and consent to the use of such material or its reproduction in any manner and by any medium which MedWish deems appropriate.
THANK YOU FOR YOUR FEEDBACK!
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