***UPDATED NOVEMBER 30TH, 2020 PLEASE READ***
As of November 30th, 2020, we are migrating to a new platform for first responders and healthcare organizations to request medical supplies to support their response to COVID-19 and this form will no longer be in use.
The new platform is a password protected storefront for requesting PPE and Medical Supplies related to the COVID-19 pandemic.
To access this new storefront, you must do the following:
1. Go to the website: https://alameda-county-emergency-medical-services-agency.myshopify.com/account/login
2. Request that an account be created by following the link above, clicking "Create Account," and then completing the form with all of the requested information, and clicking "Submit". You will then receive an email confirming your request. You will not be able to request items during this step.
3. You will receive a separate email confirming that your request for an account was approved.
4. Once you have received the email stating that your account was approved, you will then be able to access the storefront and request items that are available.
If you have any questions or difficulties while awaiting for your new account to be approved, you may send an email to: firstname.lastname@example.org