Mask Request for Health Care Workers- Chicagoland and Western Suburbs
Please use this form to request a mask for you and/or co-workers. A mask maker will contact you to arrange porch pick-up. Please note the following:

- Please provide proof of your credentials and place of employment to chicagomaskmakers@gmail.com.

- Requests for 20+ masks require documentation from a supervisor who can confirm the need.

- These masks are lined with a non-woven material, they are not as effective as N95 masks but they are something in this time of crisis and can fit over an N95. Our hope is that these will all eventually end up in the trash when proper PPE arrives.
Email address *
Name *
First and Last
Phone Number *
City of residence *
Are you a health care worker *
What are your credentials and current place of employment (e.g., RN at ABC Department, XYZ Hospital) *
You MUST include your credentials and place of work. All requests will be verified via IDPH or Linked-In. To expedite the process, please send proof of your credentials and place of employment to chicagomaskmakers@gmail.com. Requests for 20+ masks require documentation from a supervisor who can confirm the need.
How Many Masks are you requesting *
Please feel free to request additional for your hospital floor - Please indicate that in your answer. We will do our best to support you
Do you prefer Adult - Elastic; Adult - Ties, or Child masks? (we will try to meet this request if possible) *
Other questions/comments
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