Side by side. Every step of the way.

* = Required

Name*:

Address*, City*:

State*, Zip*:

Phone*: Cell:

E-mail*:

Emergency Contact Name*:

Phone*:

Relationship*:

I am interested in knowing more about:

Craft Projects
Event Planning
Event Set-up
Health Fairs
Kids Programs
Mailings
Photo Booth
Wig Salon
Receptionist
Host/Hostess for Massage Therapist
Volunteer Transportation
Other: 

Clients are eligible to receive:
  • Massage and exercise therapy
  • Transportation assistance
  • Wigs and turbans
  • Nutrition education & supplies
  • Home health supplies
  • Durable medical equipment loans