Chicago PPE Assessment of Needs
This form was made to assess the need for PPE in Chicago's emergency care settings. #GetMePPE Chicago is collecting and distributing donated PPE from the Chicagoland area. Please fill out and share this form, and we will be back in contact to help you as best we can.

Questions? Email us at GetMePPEchi@gmail.com

When submitting our form, please be aware that we place a priority on meeting the needs of institutions facing high COVID-19 positive patient burdens, high acuity, low resources, and safety-net locations.
That said, all donations we receive in excess of the needs of those locations are then equitably distributed to other healthcare workers in need.
Email Address *
Name and Title of Contact Person *
Name of ED/Facility *
Address of ED/Facility *
Phone Number *
Best Way to Contact You *
What PPE is there a shortage of? *
Required
How quickly do you anticipate needing these donated supplies? *
Do you accept open packages? *
Do you accept handmade masks? *
How many staff operate at your site daily?
How many beds does your location have (if applicable)?
Instructions for donation drop-off
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