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Request Support

 

We’re here to help make your recovery a little easier.

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If you are a breast cancer patient living in Howard County, Maryland, complete the form below to request an electric recliner or other recovery essentials.

 

All items are provided at no cost, based on availability.

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Are you filling out this form for yourself or someone else?
Myself
Someone else
Do you currently reside in Howard County?
YES
NO
What is your surgery date?
Month
Day
Year
What type of breast surgery are you having?
Single Mastectomy
Double Mastectomies
Lumpectomy
Breast Reconstruction
What recovery items are you requesting?
I understand that submitting this request does not guarantee item availability and that Karen's Closet will contact me regarding next steps.
I understand
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