MedicIndia has established wide connections with various
organizations throughout India. With your help, MedicIndia is looking to
support these organizations through medical donation. Please complete the
below form and describe the state of the product to be donated. MedicIndia
will facilitate transportation of the product overseas. Currently,
MedicIndia will not be posting NGO or organization needs. If your
organization is looking for medical donations, please contact us via email.
Please provide the following contact information:
Work Phone #:
Best reached by:
Please provide the following product information:
Please describe the product(s):
Enter the date of the product was purchased.
Please describe the state of the product. Note any scratches, dents, malfunctions, etc.
State to be donated to:
Please describe other preferences, if any: