HERO MASKS - Requests for Supplies

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If you or your organization needs supplies, please tell us about what you need, why, who and where you are. For more information, to contribute, or to help out, visit www.heromasks.org.

Please realize that worldwide supply lines are in disarray, nations are locked down, and a request placed here does not guarantee the availability of products or timelines in which it can be delivered, and requests may be only partially fulfilled depending on constantly changing supply, demand, and politics.

We will do our best to help you procure what you need for the safety of your teams and communities, but right now nobody can guarantee anything. We will review all requests and try to prioritize them based on urgency, available inventory, available sourcing, and other conditions that may arise, to try and get the best possible assistance for everybody involved.

Email *

How did you find us?

Organization Name

Job Title / Position

Title (Dr., Mr., Mrs, Ms., Sir, Her Highness, etc)

First Name *

Middle Name

Last Name *

Suffix (Jr, Sr, etc)

Address Line 1 *

Address Line 2

City *

State *

Zip Code / Postal Code *

County *

Country (if not in USA)

Shipping Address

If different from your address, above.

Mobile Phone (optional)

Authorized Purchasing Contact (if not you)

If you are not the authorized purchasing contact for this organization, please provide their name, job title, email and phone number. (This should be the person who has the authority to approve an order and get a check signed.)

Who is Asking? *

Medical Staff (hospital, urgent care)

Medical Staff (doctors offices, dentists, etc)

Police, First Responders, EMT

Need for Essential Organizational Use (business, non-profit, other group that are required to continue working for public service)

Essential Personnel (that are required to continue working for public service)

Non-Essential Personnel (that ARE NOT required to continue working for public service)

Individual for Personal/Family Use (High Risk: Over 60, Existing respiratory condition, already COVID-19 positive)

Individual for Personal/Family Use (Low Risk: Under 60, No existing respiratory conditions, COVID-negative)

Other:

Required

Urgency / Triage *

Critical - Lives at immediate risk

Urgent - People are likely to be at severe risk

High - Lower risk people caring for High-Risk people need protection

Normal - We're good now but will need soon

Low - We're good now, but it would be good to have extra on hand

Other:

Budget or Donation *

If you have a budget for purchasing these supplies, we prefer that you pay for them. They will be sold to you at-cost. We make no profit on them. (If you WANT to pay more, we will happily accept more as a donation) This allows us to then go out and replenish our stock for the next group in need. If you do not have a budget, we will donate goods as we are able.

We have a budget for purchasing (this allows us to buy replacement stock for the next need)

We do not have a budget and are looking for a donation (we do this too, but are limited by available donations)

Other:

What are you in need of? *

Select the things that you need. Provide needed quantities or other details in the next question.

Surgical Masks (more expensive, with tie strings)

Procedure Masks (cheaper, has ear-loops)

Fabric Masks (purchased or community created)

N-95 Masks (expensive, High Risk, foldable, rigid or molded)

N95 Alternatives (KN95, FFP2, FFP3)

Face Shields - Standard Medical Devices (protects eyes, nose, mouth)

Face Shields - Community Created (Open-Source projects, 3D-Printed, etc)

Nitrile Gloves

ANY Gloves (Latex, Nitrile, Neoprene)

Sanitizer

Full-body Protection ("bunny suits")

Other:

Required

Quantity *

How many of each do you need, and for how many people? More details here are better so we can plan appropriately.

Date(s) Needed *

For each item needed, when do you need it by (and what happens if you don't get it)

How Many People? *

How many people will be using the supplies? (Estimates are fine)

Are you exempt from Maryland Sales Tax? *

If you are exempt, please put your tax-exempt number or other required information below.

Normal Purchasing Sources

Where do you normally get this from, why can't you get it now? If you can share what things normally cost you, we might be able to help with your sourcing for future needs as well from original manufacturers. Anything we get in will be donated or sold at cost (for organizations with budgets), so telling us your pricing isn't going to make us raise ours. It just lets us help you better.

Additional Information

Anything else we should know?

Can we mention you? *

Can we mention your organization's name and logo when listing groups we have helped? This helps assure donors that we are actually doing what we say we will. And give you a little promotion as well.

Yes

Ask somebody else (enter the details below)

Mentioning Details

If we have your permission to mention your organization (above), what is your web site's address, who else should we contact to confirm, or any other information goes here.

Suggestions / Comments

We're always looking for ways to improve and make things easier for everybody. Please share any thoughts that might be useful!

Release of Liability - Publicly Sourced Materials

IF YOU ARE WILLING TO ACCEPT PUBLICLY SOURCED OR DONATED SUPPLIES, SIGN YOUR NAME BELOW. IF YOU WILL NOT ACCEPT PUBLICLY SOURCED PRODUCTS, DO NOT SIGN HERE AND WE YOU WILL NOT BE PUT ON ANY PUBLIC-SOURCING LISTS. I understand that these masks may sourced from un-vetted individuals, including individuals who themselves may be carrying COVID-19, and take full responsibility for the quality, efficacy, and safety of these masks and their use.I understand that these masks are sourced from un-vetted individuals, including individuals who themselves may be carrying COVID-19, and take full responsibility for the quality, efficacy, and safety of these masks and other products and their use. Enter your full legal name, phone number, and email address to accept. Leave blank if you will not accept publicly sourced materials, or if you do not have authority to sign this.

Release of Liability - Purchased Materials *

By entering my name below, I understand and accept that these personal protective equipment items are being sourced from suppliers of Hero Masks, and I take full responsibility for the quality, efficacy, and safety of these personal protective equipment items and their use. While Hero Masks attempts to properly vet all suppliers, given the urgency of the current pandemic crisis and the need for fast delivery, and the possibility of events beyond our control, including the possibility of government seizure under a claim of national security, I understand and accept these risks and agree that Hero Masks shall not bear any responsibility for any and all injuries or losses sustained that may directly or indirectly arise out of the ordering of, receipt of and or the usage of the personal protective equipment. The laws of the State of Maryland shall govern and any legal matters arising from this release of liability shall occur in Maryland. This release shall be binding on the individuals and or entity that will utilize these items and I have the proper authority to bind such individuals and or entity. Enter your full legal name, phone number, and email address to accept.

Release of Liability - Alternate Contact

If you do not have the authority to sign either of the above Releases, please provide the Full Name, Job Title, Phone Number, and Email Address of the person who has the authority to sign the release.

Send me a copy of my responses.

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