Pharmacy Surgical Mask and/or goggles Request.

Introduction, please read closely.

Pharmacies are eligible for limited access to Level 2 Surgical masks and or Goggles for the use of their staff when there is no available commercial supply. While under a "hotspot" designation P2/N95 type mask (when there is no available commercial supply) are also available for COVID Vaccinating purposes only.

In this instance, it is essential that the pharmacy staff use the masks provided in line with the advice for appropriate use of PPE, available at health.gov.au.

South Eastern Melbourne PHN can only supply to Pharmacies within our catchment. If needed please check the PHN Locator online.

Question Title

* 1. Organisation name

Question Title

* 2. Address Street and number. Line 1 (30 characters maximum)

Question Title

* 3. Address Street and number. Line 2 (30 characters maximum)

Question Title

* 4. Address Suburb

Question Title

* 5. Address Postcode

Question Title

* 6. Select your LGA (council area)

Question Title

* 7. Requesting Name

Question Title

* 8. Phone number

Question Title

* 9. Email

Question Title

* 10. Position

Question Title

* 11. Please tick what PPE you are requesting

Level 2 surgical masks

P2/N95 type masks (for COVID vaccinating purposes only)

Goggles

If requesting goggles, please indicate a number up to 30.

Question Title

* 12. Please tick here to confirm you are unable to commercially secure the PPE for your team.

We are UNABLE to commercially secure the requested PPE for our staff.

We are able to to commercially secure the requested PPE for our staff.