Request Form | Recycle Health

SUBMIT DEVICE REQUEST

Thanks for your interest in getting people healthier! Please fill out the below form. Keep an eye out for an email from us within the next week. If you haven't heard back, check your Spam or Junk folders.

Submit your request

Thanks for your interest in Recycle Health! We look forward to working with you. The first step in requesting devices is completing the below form. Keep an eye out for a follow-up email from us within two weeks (usually earlier than that) to schedule a call. At this time we only work with organizations. We don't send out devices to individuals.

Company/Organization

First name

Last name

Position

Contact Email

Phone

Shipping Address

Tell us about the program/reason you're requesting trackers

Number of devices you're requesting (guesstimate is fine)

We are a 100% volunteer-run organization. Are you able to reimburse us for shipping costs?

Yes

Not sure

We offer a program that allows people who donate their devices to be told the organization where their device was sent. Are you amenable to us telling donators their device ended up at your organization? This program is completely voluntary.

Yes you can share our name

We would prefer to not participate in this program

I'd need more information

Thanks for submitting! You should receive an email confirming your submission (check your spam/junk if you don't see it). We'll be in touch shortly to schedule a follow-up call. If you don't hear from us within two weeks please feel free to reach out.