Special Needs Solutions

Compression Vest

Fill in the necessary measurements and information below, and simply "Submit" it to us. If you have any questions, feel free to call or email us. We will be in touch.

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Person recommending equipment

First Name

Last Name

Your Name

First Name

Last Name

Email Address

Phone

(###)

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Client's Name

First Name

Last Name

Client's Birthdate

Vest Length

Top of shoulder to waist

Chest Circumference

Circumference at mid-chest

Special Instructions

Anything else you want us to know

Compression Vest

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special Needs Solutions is a tax-exempt 501(C)(3) nonprofit organization. Your gift is tax-deductible as allowed by law.