Timmins Virtual PPE Drive
Help us help you!

If you have PPE equipment (masks, gloves, gowns, visors, other) in stock and wish to let us know in case we run out and need help, please fill out the form below.

We will keep this information and call upon you if we run out!

Thank you for your kind participation!
Person/Company/Organization Name *
Contact person (if different)
Address *
Contact email address *
Telephone number *
Emergency telephone number (in case of urgent/after hours/weekend need) *
Equipment
Please provide as much information as possible regarding the equipment in the form below. Include:
- Brands
- Type of material
- Quantities
- Sizes
Masks? Please provide information about types (surgical, N95, etc.) and quantities.
Gloves? Please provide information about types, material and quantities.
Gowns? Please provide information about types and quantities.
Visors/Shields? Please provide information about types and quantities
Any other equipment ?
Submit
Never submit passwords through Google Forms.
This form was created inside of Northern Ontario School of Medicine. Report Abuse