Would you like to register?

Please tell us about yourself

Select the type of your account

Step 1 Contact

Organization

Date Organization Formed

Federal Tax ID:

Contact Name

Contact Title / Job title

Organization Address

City

State

Zip

Phone

Password

Website

We prefer to be contacted by

Step 2 Organization and Documents

Is your organization legally licensed to offer ultrasound equipment in your state?

Yes No Not applicable

Does your organization have a nurse or doctor that will be overseeing the ultrasound services operation and performing the ultrasound?

Yes No In process

If yes please provide the full name and doctor/nurse license numbers for medical personnel that will be involved in your ultrasound program

Documents

Please submit the following documents

501c3 tax exempt form

Form 990 from most recent filling

About your organization

By submitting this application I certify that I am an authorized signor for the organization and that the information provided in this application is accurate and true. I understand and agree with the Terms of Use of this website.

Please note

* Only Pro life pregnancy resource centers in the USA can register and access donations.

* You as the recipient will be responsible for any costs involved in the delivery or donated equipment to your location, along with setup/installation