Sandy PPE Order Form

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*Sandy pick up location order form.
Orders will be ready for pick up in two business days. You do not need to be a chamber member to request PPE.

NOTICE: Only small quantities are available through the Chamber. If you are looking for supplies by the case, please go to the County link below and fill out their order form https://www.clackamas.us/coronavirus/request-ppe

Email address *

First Name *

Last Name *

Business Name *

Business Street Address *

State *

Zip Code *

Phone Number *

What kind of business do you represent? *

Child Care

Food Service

Healthcare

Hospitality

Manufacturing

Non Profit Organization

Professional Services (Banking, Legal, Real Estate)

Retail

Services

Warehouse

Other:

Please select all PPE that is needed for your business. Keep in mind PPE availability is based off of inventory. We will do our best to all fulfill all orders.

3-ply Ear Loop Procedure Masks

Nonsurgical KN95 Mask(s)

Sanitizer Gel - 1 Gallon Refill

Sanitizer Gel - 2 Liter PumpBottle

Berracom Touchless IR Thermometer (limit one per business)

Face Shields

Santizer Spray

COVID-19 Antigen Rapid Test (limit three per business)

Size of your business? *

1-5 full-time employees

6-10 full-time employees

11-25 full-time employees

26-50 full-time employees

I certify that I am a small business (less than 50 employees) that has been adversely impacted by COVID-19. *

Yes

I agree none of the supplies or products I have received from the Business Recovery Center will be re-sold. *

Yes

We will contact you at the email address provided within 1-2 business days to arrange PPE pickup. If you have any questions please call 971-930-5445.

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