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Recipient, family or friendHealthcare professional

Recipient's Weight*

Recipient's weight in lbs.

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Describe your/the recipient's medical equipment need*

If we have the equipment available, where would you prefer to pick it up?*

Concord, Abiding Savior Lutheran Church, 63128, Tu & Th, 10 am - noonCrystal City, STL Warehouse, 63028, Wed & Sat, 9 am - 1:30 pmHigh Ridge, St. Martin United Church of Christ, 63049, Tu & Th, 10 am - 2 pmLemay, Aging Ahead Senior Center, 63125, Tu, 9 am - 3 pmOlivette, STLHELP Warehouse, 63132, Wed & Sat, 9 am - 1:30 pmNorth St. Louis City, Love in Action at Polish Heritage Center, St. Stanislaus Church, 63106, Fri, 10 am to noonSt. Charles, The Care Service, 63304, Fri 9 am - 3 pmSoulard, Love in Action Health and Wellness, 63104, Tu 10 am - noon

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