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The California PPE Project: Register Your Medical Supply Needs
Please fill out the following form as completely as possible, so we can help to direct grassroots PPE supply donations to healthcare centers across the state.

--Email camenta@familydocs.org at the California Academy of Family Physicians with any questions regarding healthcare center needs.

--Email katecatherall@gmail.com with any questions regarding grassroots supply donations.
Your Name *
Your Email *
Healthcare Center *
How many n95 MASKS do you anticipate needing for 1 week? Estimates are fine. *
How many SURGICAL MASKS do you anticipate needing for 1 week? Estimates are fine.
How many LATEX or NON-LATEX GLOVES do you anticipate needing for 1 week? Estimates are fine.
How much HAND SANITIZER do you anticipate needing for 1 week? Estimates are fine.
Are you accepting 3D printed face shields from the maker community at this time? *
Are you accepting home-sewn face masks at this time?
Clear selection
Is there anything else you want us to keep an eye out for, and direct your way if we can? *
What is the best way to get PPE and supplies to your healthcare center? *
If you selected shipping or drop off, please list the full mailing address OR drop off address here. *
Please designate a point of contact for your healthcare center here. *
Point of contact Email *
Point of contact phone number *
Submit
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