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Life Science - COVID-19 

Vendor Form

The Delaware Valley Industrial Resource Center (DVIRC) has created a cloud-based platform to address the growing number of supply chain inquires related to the urgent needs of medical professionals as they fight the coronavirus disease (COVID-19).

If you are a business in the region who can provide critical personal protective equipment (PPE) and /or COVID-19  related medical supplies, please complete this form
1.Company Name
2.Contact Name
3.Contact Email
4.Product Description - Please use this space to describe what it is that you can provide.
5.Product Volume - Please use this space to describe the potential volume of product that you provide.
6.Current Certifications - Please list any current certifications that you hold. 
7.Estimated Availability - If presented with a purchase order what is your estimated turn time? 
8.Personal Protection Equipment (PPE)  (Select all that apply)
9.Hospital Supplies (Select all that apply)
10.Lab Supplies  (Select all that apply)
11.Diagnostics Supplies and Instruments (Select all that apply)
12.Other products (Please specify)
13.Do you have product specifications or product images? (if yes, please send it to kenright@dvirc.org.)
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