Valley Mountain Regional Center (VMRC) has partnered with R&D Transportation along with VMRC transportation service providers for distribution of Personal Protective Equipment (PPE), free to individuals served and service providers. Hand sanitizer and other PPE may be available, while supplies last. If you are in need of PPE, please complete the request form below. 

Please Note: Forms that are not fully completed will not make it into the request system. To ensure your request is received, complete the online form below all the way to the end where a button is clicked that says "Done".

If you have any questions or need assistance filling out the form, please contact R&D Customer Service at 1-888-695-8848 Monday through Friday from 6:00 a.m. to 5:00 p.m. and a customer service representative will be happy to assist you.

Question Title

* 1. Name of Requestor

Question Title

* 2. Requestor Phone #

Question Title

* 3. Requestor E-Mail (if applicable)

Question Title

* 4. Is PPE being obtained from other sources receiving PPE from VMRC? (If so, PPE cannot also be acquired through this means)

Question Title

* 5. Is the request for a vendor or individual consumer?

T