DFWCare PPE(Personal Protective Equipment) Requests for Medical Personnels
Our website: www.dfwcare.org

This operation began as a simple conversation among friends and neighbors about what we could do to help slow the spread of CoVID19 in the US, especially concerning the DFW area.  The conversation quickly heated up when we learned that hospitals and medical personnels were running out of personal protective equipment (PPE).

Recognizing the devastation a short supply of PPE could cause, we decided to help local medical institutions prepare for the pandemic. We want to unite the community and raise money as well as PPE for the heroes who are providing emergency care and fighting CoVID19 for all of us.

This Google forum is giving the doctors and nurses a place to submit the PPE needs. Our supplies are very limited, but we will try our best to help our front-line doctors and nurses.

Sign in to Google to save your progress. Learn more
Email *
What's your name? *
What's your contact number? *
What's the full name of the medical facility's Name, Location ? (city and zip code) *
How would you describe the medical facility? *
What's your major role in your organization? *
Which group are you representing? (You can specify the department name in the comments) *
How many medical personnel are you representing for? *
Will you be able to sign waiver of liability agreement on behalf of the group/individual(s) that you are representing? *
Please sign (yourself or forward to someone who is able to sign) the waiver of liability and email to dfwdonation@gmail.com 
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy