Would Your Practice Benefit from a Vetted PPE Order?

ACCESS to AFFORDABLE PPE

AMWA is inviting all members and your associates to opt into a collective multiorganization PPE purchase auction to obtain much-needed PPE. The higher the level of participation, the greater our purchase power. Let us know what your needs are by completing the survey.

Question Title

* 1. Would you welcome the opportunity to place an order for PPE?

Yes

Not now but maybe at a future date

Question Title

* 2. What items do you need most?

N95 Masks: Indicate size

Disposable Gowns

Other (please specify)

Question Title

* 3. What is the quantity you would consider committing to? [1 carton/20 masks; 15 gowns]

1 carton

5 cartons

10 cartons

25 cartons

Other (please specify)

Question Title

* 4. What type of practice/healthcare facility are you ordering for?

Academic medical center

Community hospital

Group practice

Other (please specify)

Question Title

* 5. To receive follow-up instructions, please provide contact information.

Name

Institution

Email Address

Phone Number