Referrals

If you or someone you represent needs equipment, please complete this form, and we will be in contact as soon as possible.

  • Submitting a referral does not guarantee that Bluegrass Outreach Initiative will be able to assist. We will do our best to perform promptly, though inventory, location, and other factors can cause delays.

  • A signed waiver of liability is required to receive all equipment. Waiver for review at the bottom of the page. We also have a BoldSign e-sign form we can email you as well.

  • By entering information below, you are permitting Bluegrass Outreach Initiative to store the listed information and contact you regarding equipment donation purposes. See terms and conditions listed at the bottom of the page for more information.

  • We are working hard to finalize our inventory list and build it into the referral form. You can find an updated inventory list HERE. If items are not listed, it does not mean we cannot obtain them, but it may take longer to get.