Maricopa County Medical Society (MCMS), through items provided by the Maricopa County Department of Public Health, is distributing free PPE to medical professionals in the county. Given the high demand and limited supplies, please request PPE by completing this form. MCMS will share details about when to pick up your supplies and what has been allocated to you.

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* 1. Please provide some contact information.

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* 2. What is your medical specialty or area of focus?

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* 3. Are you a member of the Maricopa County Medical Society?

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* 4. Which items are you requesting?

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