Project C.U.R.E.

C.U.R.E. Kits

First Name *

Last Name *

Email Address *

Phone Number *

Name of organization, if affiliated? *

Name of ordering physician *

Name of recipient location *

Country of recipient location (clinic, hospital, orphanage, etc.) *

Special instructions *

Number of C.U.R.E. Kits requested *

Kit Pick-Up *

Denver Warehouse

Phoenix Warehouse

Houston Warehouse

Ship to address provided

Address *

City *

State *

Zip *

Please confirm that the C.U.R.E. Kit will be in your possession at all times until delivery *

Please confirm that you will inform Project C.U.R.E. staff if the Kit is misplaced *

International HQ
10377 E. Geddes Avenue, Centennial, CO 80112
Phone: (303) 792-0729 | Fax: (303) 792-0744
info@projectcure.org