International or Organization Supply Requests

Supplies to request from Mission Regan: medical supplies, medical equipment, diapers, formula, medications, or anything you might find in a hospital or patient care setting.

Please attach a spreadsheet list on your form. Please include details (sizes, medication strengths, etc) and general quantity needed.

Thanks for reaching out to Mission Regan! We are so thankful to be able to provide for medical needs free of charge. Please submit this form if you requesting for an organization or for an international destination.

Once your form is received, you will be contacted via email to confirm that we have received your request. Please add info@missionregan.org to your contacts list so you won't miss our message! If you have questions about what types of supplies and medications we might have available, please refer to the information sheet at the top of this page.

Include EVERYTHING you may be needing. Prioritize if some things are more important than others.

Give a date range for when supplies are needed. It may take up to a week for staff to process your list and determine if we have what you are looking for.

Please note that we do not ship supplies or make any shipping arrangements in our office. Shipping and transport arrangements will be made by you post pick up.

Indicate whether expired items are ok. (Expired supplies? Expired meds? Expired IV fluids?)

For extensive international lists, we prefer 1 month notice to allow for list processing, packing and pick up scheduling.

Let us know the volume of boxes you can pick up. Are you expecting a few boxes of supplies (10?) or do you want as many boxes as possible (1000+?).

PLEASE NOTE: Submitting this form does NOT automatically schedule your appointment to pick up your requested supplies. You will be contacted within 3 days of receiving your form to confirm we have received and are processing your request. Please allow AT LEAST 1 month for us to receive and process your request.

Primary Contact First Name

Primary Contact Last Name

Phone

Organization Name

Organization Website

Final Destination of Supplies

Please upload a typed spreadsheet of supplies and details of needs here.

(this list needs to be as detailed as possible - sizes, strengths, quantities, priorities, expired status, etc) For more information, please refer to the information at the top of this page.

Upload Supply List

What is your status on taking expired supplies

Expired supplies are ok

We cannot take any expired supplies

I will give more information in Additional Notes on the next page

How do you plan to transport supplies to destination

How many boxes are you prepared to accept -- A few boxes (10?) or as many as possible (1000+)?

What is your timeline for picking up supplies? (Keep in mind we may need up to ONE MONTH to prepare a larger supply list for pick up.)