Request Equipment

Devices 4 the Disabled provides refurbished medical equipment at no cost to individuals in need. Equipment is subject to availability and suitability for each recipient’s needs. Submitting a request does not guarantee that equipment can be provided.

Some requests require clinical documentation, an assessment, or an equipment fitting. Equipment is provided through scheduled pickup at D4D’s Ed Kane Center in Chicago. Please arrange appropriate transportation, particularly for large or heavy equipment.

Have a question before submitting your request? Please use our Contact Us form, and our team will follow up with you.

D4D Request Equipment

About This Request

Start by telling us who needs equipment. The questions that follow will adjust based on your answer.

Choose an option to continue. Additional questions will appear below.

About the Recipient

Recipient Information

Living Arrangement & Location

Recipient's Address or Location

If there is no fixed address, provide the city, ZIP code, or general area if known.

Primary Contact

Additional Recipient Information (Optional)

These questions are optional and do not affect eligibility.

Choose...
Choose...

Include the recipient and people who live together and share income.

Include income for the people counted above.

Equipment Needs & Request

Select equipment...
Mobility
Bathroom Safety
Bedroom
Transfers
Positioning & Seating
Therapy & Rehabilitation
Health Monitoring
Pediatric
Bariatric
Restricted Clinical Equipment
Other

Select all that apply.

Recipient Height & Weight

Please provide the recipient's height and weight. This helps D4D identify equipment that may be a good fit.

D4D may need these measurements before equipment can be selected or an appointment can be scheduled.

Care & Access

Healthcare

Insurance & Access

Additional Information

Review & Submit

Review your information before submitting.

What happens next?

D4D will review the request and follow up if more information is needed. Equipment is based on availability and is not guaranteed.

Equipment Responsibility

If equipment is provided, the recipient or their representative will be responsible for its care and use.

Measurements for Wheelchair:
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