AmeriCares-Zimmer Donation Program
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AmeriCares considers requests from U.S.-licensed physicians performing charitable surgeries on domestic or overseas medical trips. While our goal is to support as many charitable surgeries as possible, we will not always be able to fulfill 100 percent of each request.
| DOMESTIC SURGERIES |
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1.
Download and Fill Out the Domestic Application
(PDF) |
(Word)
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2.
Submit Domestic Application
Zimmer Domestic Surgery forms can be completed electronically, saved and emailed to us or printed and faxed to us at 203-406-4433. A typed signature is acceptable.
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| OVERSEAS TRIPS |
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1.
Download and Fill Out the Required Additional Zimmer Forms
(PDF) |
(Word) |
These forms can be completed electronically, saved and emailed to us or printed and faxed to us at 203-406-4433. A typed signature is acceptable.
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2.
You will need to complete our standard Online Application for overseas donation requests.
Because there are terms and conditions unique to the Zimmer donation process, we also require that you complete a Zimmer Addendum & Inventory and submit them along with a copy of your current state medical license.
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