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  • Eligibility Requirements


    911Emerge-N-See seeks to partner with organizations, entities, and individuals who share our goal to provide lifesaving/enhanced service to serve those in need through its core competencies, services, and products such as:

    • Disaster Assessment & Response Team - Members unilaterally manage or seamlessly integrate into your emergency response structure to apply skills, competence and experience.
    • Tracking & Supply Chain Management – Real-time tracking, enhanced transparency & accountability, & improved efficiency & optimization.
    • Purchased & Donated Medical – Maximized through partnership and agreement with leading implementing agencies, pharmaceutical, medical supply, and humanitarian organizations.
    • Training, Monitoring and Evaluation - We provide ongoing reports itemizing how medicines, supplies and services are utilized effectively. This commitment often includes our training those individuals according to international ‘best practices’ standards – building local capacity in the process.
    • Donor Relations - Donors are the life blood of disaster relief efforts. 911 Emerge•N•See has a team of skilled marketing professionals to help get your message out.
       

    911ENS complies with U.S. export controls and screens all applicants according to government-published lists prior to approving/releasing any shipment.

    Applicants must possess sufficient funding to cover 911ENS service fees, shipping costs and any charges related to customs clearance.

    The applicant must provide the following information and materials:

    • Proof of charitable, non-profit status (if applicable) or programmatic provisions of services and/or goods to those in need.
    • Completed and signed eligibility forms.
    • Written and verbal testament of recommendation from a partner organization, individuals and programmatic or religious institutions.
    • Recent annual report.
    • Descriptive promotional literature regarding your organization, program, or project.

    The process to confirm eligibility to receive services, medicines, supplies, and related support begins and is determined based on the completed eligibility forms and materials itemized above.  Continued eligibility will be dependent upon reports corroborating compliance with 911ENS standards, guidelines, policies, and procedures.

    911ENS policy prohibits the transport of medicines or medical products to any U.S.-embargoed country, or ones subject to economic sanctions, e.g. Cuba, Syria, Iran, Sudan, etc. without the ordering partner providing proof of required licensing from appropriate authorities within the U.S. government.

  • Guidelines

    1.   Limited Stock: Distinct from 911 ENS’s provision of purchased generics and branded medicines and supplies: 911ENS’s providers of donated inventory are primarily dependent on donations from the U.S. pharmaceutical industry; types and quantities of available medicines and medical supplies can vary.

    2.   Product Use: In compliance with the Food, Drug and Cosmetic Act, as amended, and Internal Revenue Service regulations, all donated products must be used exclusively for the treatment of the ill, needy and infants and may NOT be sold or exchanged for property or services or re-exported.  All prescription medicines must be prescribed on-site by a qualified medical professional only.  Adequate records must be maintained to document the proper and efficient handling and distribution of all medicines.

    All recipients of 911 ENS-provided services and products assume full responsibility that all medicines and medical supplies donated for programs outside the United States will be used only for those programs stated at the time of request. No product may be left behind in the U.S. or brought back to the U.S. at the end of the mission. Recipients must notify 911Emerge-N-See prior to any changes to the original plan and request.

    All recipients will be required to submit a detailed plan for the storage and distribution of any unused medicines with a full report of the disposition to be completed upon return.

    All dated medicines and products provided/shipped by 911ENS sources must be dispensed and used prior to their expiration date.

    In the case where 911ENS-provided medicines/supplies/products must be destroyed, notification must be given to 911ENS prior to any related action.  The recipient must handle that product in compliance with the original manufacturer’s recommendations and the recipient country’s rules, regulations, and laws.  Failure to notify 911ENS may result in loss of eligibility for future shipments and other actions.

    All 911ENS partners must immediately report any adverse event potentially related to 911ENS-supplied medicines, supplies and/or products by calling 911Emerge-N-See at (470) 319-3118 and emailing or emailing/faxing the completed Adverse Event Report form to info@911emergensee.com or (912) 638-1883.

    3.   Customs: Clearing Customs is the responsibility of the consignee/recipient.  Documents are carefully prepared to assist in this process (e.g. detailed packing list, gift certificate, invoice).  911Emerge-N-See is not responsible for customs charges, fines or taxes. Should medicines/supplies/products be confiscated by customs officials and not released for its intended use, 911ENS must be notified immediately after discovery.

    4.   Security: Donations from pharmaceutical and medical supply companies are dependent upon the product being transported and dispensed in a secure manner upon receipt. 911ENS partners must exercise caution when making arrangements in other countries.  Shipments to locations in the U.S. for international transport should be opened only AFTER their arrival to the overseas destination.

    5.   Service Fee: To sustain provision of its life-saving-enhancing services/supplies/products, service fees are established for all shipments to recover a portion of 911ENS’s total annual cost to procure, receive, inventory, audit, process, and ship the donated and/or purchased medicines/supplies.

    6.   Reporting: All recipients of 911ENS-supplied medicines and medical supplies are required to complete and return the delivery confirmation form and submit distribution and impact reports to 911ENS, including human-interest stories and photographs. The submitted information including photographs and stories may be used by 911Emerge-N-See, its donors and mission partners to promote 911ENS’s mission and work around the globe.  Photos will remain the property of 911Emerge-N-See, will be shared with 911Emerge-N-See donors and will not be provided to other agents or sold for profit.

  • 153 Follins Lane | St. Simons Island, GA  31522 | Phone: 470.319.3118 | Fax: 912.638.1883 | dominic@911emergensee.com

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  • The following documents must accompany the submission of this form:

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  • Principle Staff:

     

    Executive:

  • Finance:

  • Programs:

  • Logistics:

  • Public Relations:

  • Prefessional References:

  • Scope of Work:

  • WHO Guidelines

    By signing this statement, the undersigned affirms the basic principles of the WHO Guidelines for Drug Donations, including the following:

    1.      All drug donations should be based on an expressed need and be relevant to the disease pattern of the recipient country. Drugs should not be sent without prior consent by the recipient country.

    2.      The presentation, strength and formulation of donated drugs should, as much as possible, be similar to those commonly used in the recipient country.

    3.      All donated drugs should be obtained from a reliable source and comply with quality standards in both donor and recipient country.

    4.      After arrival in the recipient country all donated drugs should have adequate shelf-life for distribution and use prior to expiration.

    Recipients should be informed of all drug donations that are being considered, prepared or are actually underway.

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  • Signature of Agreement for Acceptance and Distribution

    By signing this statement, the undersigned agrees with 911ENS’s Mission and Vision statement and all conditions of service as explained in the Eligibility and Guidelines, including, but not limited to, the following:

    1.     All donated product received from 911Emerge-N-See will be used exclusively in charitable work outside the U.S., in a U.S. indigent clinic, and/or in the designated country only and will not be re-exported either to the U.S. or a third country or transferred in exchange for money, other property or services.  Violation of this condition may result in prosecution to the fullest extent of the law and/or civil suit.

    2.     All non-delivery/non-distribution of product due to damage, customs problems or excess amount will be reported to 911ENS immediately.

    3.     All dated medicines and products shipped by 911ENS must be dispensed prior to their expiration date or destroyed in accordance with the original manufacturer’s recommendations and the recipient country’s regulations.

    4.     In case of a product recall, all recipients will adhere to 911ENS’s recall policies and procedures.

    5.     All 911ENS partners must immediately report any adverse event potentially related to 911ENS-supplied medicines, supplies and/or products by calling 911Emerge-N-See at (470) 319-3118 and emailing or faxing the completed Adverse Event Report form to mark@911emergensee.com or (912) 638-1883.

    6.     All partner recipients of 911ENS-supplied medicines and medical supplies are required to complete and return the delivery confirmation form and submit distribution and impact reports to 911ENS, including human-interest stories and photographs.  The submitted information including photographs and stories may be used by 911ENS, its donors and mission partners to promote 911ENS’s mission and work around the globe.  Photos will remain the property of 911ENS, will be shared with 911ENS donors and will not be provided to other agents or sold for profit.

    7.     911Emerge-N-See reserves the right to review continued partnership eligibility based on compliance with reporting.

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  • 153 Follins Lane | St. Simons Island, GA  31522 | Phone: 470.319.3118 | Fax: 912.638.1883 | dominic@911emergensee.com

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  • All partners requesting prescription medicines and/or surgical supplies must provide this form, completed and signed by the licensed practitioner whose current state license and DEA numbers are included.

    By completing and signing this form, the licensed healthcare practitioner assumes full responsibility for medicines and medical supplies provided by 911ENS.  All medicines and medical supplies are to be used only in mission work outside of the United States of America and in compliance with the U.S. Food, Drug and Cosmetic Act, as amended, and all other applicable U.S. laws and regulations.  The practitioner agrees that these medicines and supplies will not be marketed in the United States nor returned to the United States, nor sold or exchanged for property or services.  All medicines and medical supplies will be used only in treating the ill, the needy and infants.

    If these supplies are lost, confiscated, or stolen prior to arriving at their ultimate destination, report the situation immediately to 911Emerge-N-See by phone (470-319-3118), fax (912-638-1883), or email (dominic@911emergensee.com).

    911ENS verifies with state medical boards that all license numbers are current.

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  • If the ordered products are not to be shipped by 911ENS to the practitioner above, provide the name and address of the authorized recipient:

  • 153 Follins Lane | St. Simons Island, GA  31522 | Phone: 470.319.3118 | Fax: 912.638.1883 | dominic@911emergensee.com

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  • 911Emerge-N-See is diligent in following where our medicines/supplies are distributed and how people are being treated and healed. We require details about your health development projects to enable us to serve you better and share our partnership with others. We expect to receive your Confirmation of Delivery form immediately following receipt of the shipment and your Distribution and Impact Reports, including impact stories, photos and/or video, within three to six months after the arrival of the shipment in the country of destination.

  • 911ENS Use Account Number:   Account Name:  
  • Section A: Partner Information

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  • Section B: Shipment Consignee Information

  • Section C: Recipient Organizations/Medical Facilities

    If additional space is required, please include your list of recipients as a separate attachment.

  • Recipient #1

  • Recipient #2

  • Recipient #3

  • Recipient #4

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  • Section D: Distribution Plan

  • Section E: Transportation and Storage Plan

  • Section F: Project Information

     

    Project Target Population

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    Project Focus

  • Section G: Product Needs

  • Categories of medicines and medical supplies most needed (check all that apply):

  • 153 Follins Lane | St. Simons Island, GA  31522 | Phone: 470.319.3118 | Fax: 912.638.1883 | dominic@911emergensee.com

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  • Donee hereby accepts responsibility for export clearance and export license determination requirements with respect to all transactions between 911Emerge-N-See and Donee.

    Donee or its duly authorized agent in the United States shall be deemed the exporter for purposes of all applicable U.S. laws.  This acceptance shall remain in effect until cancelled in writing by Donee and written notification of such cancellation is received by 911ENS.  

    Without limiting the foregoing acceptance of export compliance responsibility, Donee agrees to comply with all applicable U.S. economic sanctions and export control laws and regulations, including the U.S. Export Administration Regulations and U.S. Treasury Department economic sanctions regulations. Donee covenants that it shall not -- directly or indirectly -- sell, export, reexport, transfer, provide, donate, divert, loan, lease, consign, or otherwise dispose of any items received from 911Emerge-N-See to or via any person, entity, or destination, or for any use prohibited by the laws or regulations of the United States or any other applicable jurisdiction without obtaining any and all prior governmental authorizations required by law.  Notwithstanding any other agreement, neither Donee nor 911Emerge-N-See shall take or refrain from taking any action prohibited or penalized under the laws of the United States or any applicable foreign jurisdiction.

    Donee’s breach of this covenant shall constitute cause for immediate termination of the Agreement between the parties.  Donee agrees to indemnify and hold harmless 911Emerge-N-See and its affiliates for Donee’s noncompliance with these controls in connection with the items.  This covenant and all remedies provided in relation thereto shall survive termination or cancellation of this acceptance of responsibility.

    To ensure that 911Emerge-N-See has complete records with respect to such transactions, Donee shall, at 911ENS’s request, provide 911Emerge-N-See with copies of any and all export documents, including export licenses or other bases for export authorization and the Shippers Export Declarations or AES records filed, with respect to any transactions in which Donee has received items from 911ENS.  

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