PPE Face Shield Request Form
We know that many local providers and individuals need PPE to keep them safe. We will review requests on a case-by-case basis and consult with our team of makers to make sure we're providing equitable access to those who need it most.

We aim to provide resources for medical, safety, and vulnerable populations. This includes frontline workers in areas such as: hospitals, medical facilities, dental facilities, home healthcare, hospice, morgues (medical examiners), police, fire/EMS, corrections, justice centers, among others.

We also wish to assist vulnerable individuals, including those who are immunocompromised, breathing impaired, or otherwise unable to wear a mask for medical reasons.

See our website (www.maplepta.com) for a list of current PPE recipients.
Email address *
Your Name *
Name of Recipient/Organization *
Pickup in North Olmsted (address will be emailed) or Delivery Address *
Desired Number of PPE Face Shields *
Official Name of Organization We Can Publicly List as Recipient of PPE (if applicable)
Which Describes PPE Need (check all that apply) *
Required
Anything else we should know?
A copy of your responses will be emailed to the address you provided.
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