Team Participation Form


If you are unable to complete the form online, you may download as a pdf,
complete and email a scanned copy to or fax to (219) 922-1694.

Online Team Participant Information Form

May 07 2021

Cleft Lip/Palate Surgery, Dental Clinics, A1C & Iron Testing, Construction Project (Washington State University)

Jul 16 2021

 Vision Clinics, Helping Babies Breathe Clinics, Construction Project, possibly General Medical Clinic

Jul 23 2021

 Occupational Therapy Clinics (Grand Valley State University)

Oct 08 2021

 Orthopedic Surgery, Physical Therapy Clinics, General Medical Clinics, Construction Project, Vision Clinics, Helping Babies Breathe


Phone: 219-924-2446
Fax: 219-922-1694
2210 US 41
Schererville, Indiana 46375
Click here to email

Guatemala Office

Barrio La Barca
Gualan, Zacapa
Guatemala, Central America

Kentucky Office

2601 Evergreen Wynde
Louisville, KY. 40223
Phone 502-523-2695

Oklahoma Office

1203 East 30th Place
Tulsa, OK. 74114
Phone 281-684-9741

Wisconsin Office

S67 W32615 Ashton Way E
Mukwonago, WI. 53149
Phone 262-490-7009