Submit Progress Report & Order

Prior to resupply of Diflucan®, each organization is required to submit a Progress Report describing how the previous donation was used. At the time of submitting the Progress Report, each organization will be able to submit a resupply request. The Diflucan® Partnership Program reserves the right to amend this request based on information collected on the organization’s program.

To complete a progress report and order, please download the form . Note: to read, edit and save this form, you must have Adobe Acrobat 8.0 or later. Visit http://get.adobe.com/reader/ to download the most current version.

When you have completed the form, please send it as an email attachment to diflucanpartnership@directrelief.org.

Download the Progress Report and Order Form

If you have questions, email us at diflucanpartnership@directrelief.org

Contact us by phone in South Africa:
+27 11 351 1287

In the U.S.:
+1 805 964 4767

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Direct Relief is a registered 501(c)(3) organization.
Direct Relief
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Santa Barbara, CA 93117
Phone: (805) 964-4767
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