Cure SMA Teen & Adult Support Package Request Form

Please fill out the form below to request a Cure SMA Support Package if you haven't received one previously. Upon submitting the request form below we will ship out your support package in the order it was received. Please email supportpackage@curesma.org with any questions. Also, please note we are unable to ship to PO boxes.

Package Includes:

Medical Fleece Ease Sheepskin
Amazon Echo
Telescopic Back Scratcher
Long Grabber Reacher Tool
Gooseneck Phone or Tablet Mount
Etekcity Remote Control Outlet Switch Kit
EZ-Shampoo Hair Washing Basin
Neck and Shoulder Heating Pad
Sisu Positioner Pillow

1. I acknowledge I have read through the eligibility criteria below and meet all of the requirements.

Eligibility Criteria:

Must have confirmed SMA diagnosis.
Must be 13 years of age or older.
Must live within the US.

*This question is required.

Are you affected by SMA or are you filling out this request on behalf of a person with SMA? *This question is required.