Doctor and Nurse Small Order Request
Despite the immediate need, crisis conditions sometimes cause inefficiencies. On days when we have excess capacity we set aside small quantities for purchases directly by doctors, nurses and their families. If you would like to purchase small quantities for your direct personal use, please fill out this form.
Email address *
How many 3-ply, surgical style masks?
Provide a quantity that is a multiple of 50 or 2,500.
How many N95 or KN95 masks?
THESE ARE NOT CURRENTLY AVAILABLE, BUT WE WILL LET YOU KNOW WHEN WE HAVE INVENTORY.
How many COVID-19 testing kits?
THESE ARE NO LONGER AVAILABLE. IF WE ARE ABLE TO PROCURE THEM PROVIDE DESIRED QUANTITY.
What other questions or comments do you have?
Your Name *
Profession or Title
Organization
How did you hear about us?
Address Line 1 *
Address Line 2
City *
State *
Zip Code *
Best Phone number *
Can we text this number? *
What time zone are you in? What is the best time of day to call?
A copy of your responses will be emailed to the address you provided.
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