PPE Donation Request - AAP Orange County Chapter

The AAP-OC Chapter would like to support our medical providers who are in need of personal protective equipment (PPE) for their practice during COVID-19. We are seeking the following:

Disinfecting Spray
Disinfecting Wipes
Hand Sanitizer
Gloves
N95 Masks
Surgical Masks
Gowns
Alcohol Wipes

The AAP-OC will be in contact with you to coordinate the best method to direct supplies where they are needed. Thank you!

Question Title

* 1. Contact Information

First Name

Last Name

Email Address

Contact Phone Number

Address

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* 2. Please select the Personal Protective Equipment you are able to donate.

Disinfecting Spray

Disinfecting Wipes

Hand Sanitizer

Gloves

Masks

Gowns

Alcohol

Not Applicable (N/A)

Other (please specify)

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* 3. How many units of each item do you have in stock that you will donate?

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* 4. What is the earliest date you could donate the units?

Date / Time

Date

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* 5. Are you able to deliver or ship items to practices in Orange County?

Yes

The OC Healthcare Agency is also accepting requests for health-related supplies. Guidance on making a request from the County of Orange can be found on the HCA –Agency Operations Center webpage at: www.healthdisasteroc.org/ems/health_emergency_management/hca_agency_operations_center

PPE Donation Request - AAP Orange County Chapter

Question Title

* 1. Contact Information

Question Title

* 2. Please select the Personal Protective Equipment you are able to donate.

Question Title

* 3. How many units of each item do you have in stock that you will donate?

Question Title

* 4. What is the earliest date you could donate the units?

Question Title

* 5. Are you able to deliver or ship items to practices in Orange County?

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* 6. Please share any other comments or questions with us here and we will follow-up with you as soon as possible.