University Hospital - PPE Donation Form
The University of South Alabama community is working hard to ensure that we continue to provide the best care to those who need it. In this extraordinary time, supplies are needed for our frontline healthcare staff.

Donations of critical supplies are being accepted including protective equipment and sanitizing items.

Please note:
โ€ข We cannot accept any other supplies at this time and must keep storage space at our donation sites available for the items on this form.
โ€ข ๐‡๐จ๐ฆ๐ž๐ฆ๐š๐๐ž ๐จ๐ซ ๐Ÿ๐š๐›๐ซ๐ข๐œ ๐ฆ๐š๐ฌ๐ค๐ฌ ๐š๐ง๐ ๐ ๐จ๐ฐ๐ง๐ฌ ๐œ๐š๐ง๐ง๐จ๐ญ ๐›๐ž ๐š๐œ๐œ๐ž๐ฉ๐ญ๐ž๐ ๐š๐ญ ๐ญ๐ก๐ข๐ฌ ๐ญ๐ข๐ฆ๐ž. ๐˜๐จ๐ฎ ๐ฆ๐š๐ฒ ๐ฐ๐š๐ง๐ญ ๐ญ๐จ ๐œ๐จ๐ง๐ฌ๐ข๐๐ž๐ซ ๐Ÿ๐ข๐ซ๐ฌ๐ญ ๐ซ๐ž๐ฌ๐ฉ๐จ๐ง๐๐ž๐ซ๐ฌ ๐จ๐ซ ๐จ๐ญ๐ก๐ž๐ซ ๐ ๐ซ๐จ๐ฎ๐ฉ๐ฌ ๐ฐ๐ก๐ข๐œ๐ก ๐ฆ๐š๐ฒ ๐ก๐š๐ฏ๐ž ๐ง๐ž๐ž๐ ๐Ÿ๐จ๐ซ ๐ญ๐ก๐ข๐ฌ ๐๐จ๐ง๐š๐ญ๐ข๐จ๐ง.
โ€ข All donated items will be sent to and used by healthcare personnel at University Hospital, Children and Womenโ€™s Hospital, and the Mitchell Cancer Institute.
โ€ข All donations must be in original and unopened packaging.

Please complete and submit the form below ๐Ÿ๐จ๐ซ ๐š๐ง๐ฒ ๐ข๐ญ๐ž๐ฆ๐ฌ ๐ฒ๐จ๐ฎ ๐ฐ๐จ๐ฎ๐ฅ๐ ๐ฅ๐ข๐ค๐ž ๐ญ๐จ ๐๐จ๐ง๐š๐ญ๐ž ๐Ÿ๐ซ๐จ๐ฆ ๐€๐ฉ๐ซ๐ข๐ฅ ๐Ÿ, ๐Ÿ๐ŸŽ๐Ÿ๐ŸŽ ๐š๐ง๐ ๐›๐ž๐ฒ๐จ๐ง๐. Items detailed on the form will be reviewed by Health System personnel. If the items are determined useful at the current time, instructions about drop off will be sent to the individual listed in the contact information.
PI Name: *
Location (Building/Room#): *
Contact Email: *
Contact Phone: *
Were these donations purchased with a federally-sponsored award? *
If funding was provided by a non-federal sponsor, do you have authorization to donate these items?
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