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Request Support

TRIMEDX Foundation accepts applications for biomedical equipment repair and facilities maintenance support from medical facilities and medical surplus recovery organizations.

Organization Name*

Who owns/operates the facility?

Year Established

Average number of patients treated per month*

Contact First Name*

Contact Last Name*

Title

Email Address*

Phone

Address, line 1

City

Zip Code

State

Country*

Please list medical services provided.*

Does the hospital have guest facilities?

Yes No

Do you have an up to date list of equipment inventory?

Yes No

What percentage of current medical equipment is working?

Have you ever used paid or volunteer repair services?

No Selection Volunteer Paid Both

What are the hospitals current needs?

We will never share your email address. Ever.

Submit Application

Contact Us
Org Email | Org Phone