Mission Regan DME Grandview- Requesting DURABLE MEDICAL EQUIPMENT
Thanks for reaching out to Mission Regan! Please submit this form if you need to request THESE SPECIFIC DME (www.tinyurl.com/mrdmegv). Once your form is received, you will be contacted via email with an appointment time and location to pick up in Grandview. Please note that we ONLY have these specific Durable Medical Equipment items (www.tinyurl.com/mrdmegv) to request.

Please allow at least 3 business days for a pick up appointment to be scheduled. (check spam and junk if you do not see an email)

For more information regarding Mission Regan and what we do, please check out our website at www.missionregan.org.


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Email *
Name (First & Last - if Organization, please list IN ADDITION to your name) *
Contact Phone *
What DURABLE MEDICAL EQUIPMENT do you need? (These are the ONLY equipment options we offer: www.tinyurl.com/mrdmegv) Please note that we rely on equipment donations IN to give equipment donations OUT, so our available equipment varies. Please do not request items not listed on the link above. NOTE:  YOU ARE REQUESTING FOR PICK UP IN THE SOUTH FORT WORTH AREA *
Please give height and weight of person using the requested equipment so we know if we have the right size equipment available. *
What day of the week would you like to schedule an appointment to pick up in Grandview? (SOUTH FORT WORTH AREA) *
What time of day would you like to schedule an appointment?  (SOUTH FORT WORTH AREA *
Additional notes
If you have a file with supply details, please email to dmegrandview@missionregan.org
Want to make sure Mission Regan can continue to help those in need in our local community and all around the world?  Donate at https://missionregan.com/donate.html, text MRdonate to 76278 or scan the QR Code below.
A copy of your responses will be emailed to the address you provided.
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