Record of PPE Donations in response to COVID-19 epidemic

Please note the type and amounts of PPE you have donated on the form below, and be sure to add your personal information at the end. Thank you for donating!  Please submit your information by April 27.

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* 1. Please note the total number of gloves donated from your personal supply.

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* 2. Please note the total number of masks donated from your personal supply.

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* 3. Please note the total number of gowns donated from your personal supply.

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* 4. Have you donated items other than those listed above?

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