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COVID-19 Critical Supplies Survey

Is your company able to assist in the production of critical supplies?

Our nation is needing manufacturers who can provide and/or produce large-scale quantities of critical supplies to help respond to the COVID-19 pandemic.

Please complete this brief survey about your production ability. Due to the urgency of the request for information, we are attempting to receive responses ASAP. 
Contact Information:
Which of the following supplies can you provide and/or produce? (Check all that apply.)
For each supply checked, please specify the product model number and include the quantity.
For each supply checked, please include the city and state of the facility that would produce and/or provide the supply.
Are there any supplies or other provisions that you could donate to the nation’s COVID-19 pandemic response?
Who should be the point of contact for any follow-up requests from the Administration?