PPE Resource Request Form

Please complete the following form to order your N95 supplies.

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Thank you for being an N95 distribution partner and helping to provide critical N95 masks to organizations within your local community.

Use this form to place your N95 mask order for your center. You will provide a 30-day supply of masks to an organization's unvaccinated workers.

When placing your order keep in mind the following case pack information for storage and distribution purposes:

        1 Box: 20 masks

        1 Case: 48 boxes

 

To determine the quantity of masks to order please consider your storage capacity and the following:

  • The number of days per week you are distributing.

  • The number of time slots per day. 

  • The capacity of recipients per time slot.

  • The number of weeks you are participating in the program.

 

Example - Partner chooses to distribute Mondays and Wednesdays from 10-1pm with a capacity of 5 recipients per hourly time slot over a 4 week period. 

Max Order Quantity = 2 days x 3 hours a day x 5 recipients per hour x 4 weeks x 5 average unvaccinated workers per recipient = 600 boxes. That would translate to an order of 12,000 masks (600 boxes x 20 masks per box).

PPE Order Form

Thanks for your order. A representative will confirm your order shortly.