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Request Supplies

If you or someone you know needs diabetes supplies, you’re in the right place. T1D Fire works to connect individuals with the resources they need as quickly as possible—especially in urgent situations. Please complete the form below so we can understand your needs and respond appropriately. If your situation is urgent, be sure to indicate that clearly. All requests are reviewed as quickly as possible. Supplies are limited and not guaranteed.

Please complete the form.

We will get back to you shortly.

What supplies are you requesting?
Do you have a prescription for the requested items?
How urgent is your need?
Multi-line address
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