COVID-19 Face Shield Request
This form is to be used to request face shields as shown on our website. https://making.engr.wisc.edu/shield/

How it works:
- Through publication of the University of Wisconsin’s open source face shield design, a community of manufacturers of varying sizes has formed, many of which have adapted part of their production line to make these shields.

- Filling out the form below will enter your organization into an early version of an online matching system that co-ordinates communication between healthcare organizations in need of face shields and manufacturers that are producing them.

- Once you are matched with a manufacturer, you will receive an email with their contact information and further instructions.
   
- Please note that due to possible supply constraints, healthcare facilities may be matched with multiple manufacturers over multiple rounds. This system is for co-ordinating matches between healthcare facilities and face shield manufacturers only; we do not handle billing or payment.
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Organization Name *
Facility Type *
Number of Beds You Service *
Number of healthcare workers / medical staff *
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