Mask Announcement from BCIL

BCIL has obtained another limited supply of masks and gloves.

Please fill out the form in order to obtain masks and/or gloves from BCIL. If you can’t use the form for any reason, please leave your name, address and need for masks at 617-338-6665.

If you are on the PCA program, your PCA can obtain masks from 1199SEIU, the PCA union, by going to this link: www.bit.ly/ppe1199 .

We ask that you do not request masks or gloves if you currently have a supply— we wish to focus on those persons who are in short supply or have none.

Question Title

* 1. Registration information

Name *

Address *

City/Town *

State/Province *

ZIP/Postal Code *

Email Address (optional)

Phone Number (optional)

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* 2. Are you requesting masks or gloves or both?

Masks

Gloves

Masks and gloves

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* 3. Are you on the PCA program?

Yes

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* 4. How many PCAs do you have?

Other (please specify)

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* 5. Do you receive other in-home services, and if so, what kind?

Yes

If yes, what home services do you receive?

Mask Announcement from BCIL

Question Title

* 1. Registration information

Question Title

* 2. Are you requesting masks or gloves or both?

Question Title

* 3. Are you on the PCA program?

Question Title

* 4. How many PCAs do you have?

Question Title

* 5. Do you receive other in-home services, and if so, what kind?

Question Title

* 6. Is there anything additional you would like BCIL to know?