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Stand With Me Pediatric Supine Standing Frame Request Form
Please visit www.standwithme.org to learn more about our standing frames, and find out if it is right for your patients. The SWM supine standing frame has a height maximum of 110cm.

After filling out this form, you will be placed on our waiting list for standing frames. We will do our best to service your needs in a timely manner.

Are you associated with a nonprofit organization *
Are you a therapist?
Which nonprofit are you associated with?
In what country is the need? *
How many standing frames do you need? *
Your answer
How many standing frames do you need? *
Your answer
What is your email address? *
Your answer
If known, what are the ages and heights of the children who will be receiving the standing frames? (ex. Age 3, 90cm)
Your answer
Is there any other information you would like us to know so we can best fill your order?
Your answer
How did you hear about Stand With Me *
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