PROSTHETIC LEG REQUEST

Are you a clinic?

Are you a prosthetic clinic and have a list of amputees who need prosthetic legs?  We work with clinics to obtain donated prosthetic components to help low income, underserved amputees who are not provided for by government insurance.  So that we can get the appropriate components, please download this spreadsheet and fill out the details. 
Spreadsheet provided in Google Sheets and Excel Spreadsheet formats.
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Copy Google Sheet

Download Excel Spreadsheet

​Once completed, please email to info@2ftprosthetics.org.

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Are you an Amputee?

If you live outside of the United States, have a low income, and are in need of a prosthetic leg, please fill out our prosthetic leg request form by clicking on the button below.  We only have services in a few areas of the world right now, but if we have services in your area and are able to assist, we will contact you with details of our next trip to your area. Or if we are aware of a clinic in your area, we will connect you with them.  If we ever open services in your area, we will reach out to you at that point.  

Prosthetic Leg Request