Kits4Life Site Offer | MedSurplus Alliance

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Sponsor and CRO Donation Offer Form

kits4life Product Offer

Clinical Research Site Form

Contact Information

Kit Product Categories

Unknown

Tubes

Needles

Tourniquets

Syringes ECG Supplies

Spirometer

Pipettes

Hubs

Slides

Urine Collection Cups/Tubes

Unlabeled Items

Includes Expired Items

Equipment (Describe in comment box.)

Estimated Quantity

Less than 20 Kits

20 or More Kits

Bulk Cases

Other - Please describe in comment box.

Estimated Expiration Dates - Choose all that apply.

Expires in 12 months or more

Expires in 6-12 months

Expires in 6 months for less

Expired

Unknown

Not Applicable

Do you have permission to donate the products?

Yes - Sponsor

Yes - Trial Site

No - Sponsor

No - Trial Site

Other - Please describe in comments box.

Upload Options

Upload One Inventory List

Upload File #1

Upload supported file (Max 15MB)

Upload One Inventory List

Upload File #2

Upload supported file (Max 15MB)

Upload One Inventory List

Upload File #3

Upload supported file (Max 15MB)

Upload One Product Photo

Upload Photo #1

Upload supported file (Max 15MB)

Upload One Product Photo

Upload Photo #2

Upload supported file (Max 15MB)

Upload One Product Photo

Upload Photo #3

Upload supported file (Max 15MB)

Donation Offer Received, Thank You!

A confirmation email has been sent to the address provided.

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