Request Home Delivery

To receive your therapeutic craft kit, please provide the information requested below. The information will be kept strictly confidential and will not leave the organization for any reason.

All fields are required.  

Active Duty   Reserve Duty
Years of Service * to

Please attach your evidence of eligibility. 

Acceptable items:

  • Any document that identifies applicant serves or served in the U.S. military;
  • Any document that identifies applicant has received medical or nursing care in the last six months. (Example: Receipt from doctor visit; notice of past appointments, etc.)