Personal Protective Equipment Critical Supply Survey

Please complete if you are experiencing a critical supply of personal protective equipment

Ontario Health (Toronto Region) is surveying local Toronto community practices to find our which offices have run out, or have a critical supply, of PPE.

Public Health Ontario recommends DROPLET precautions for Care of Individuals with Suspect or Confirmed COVID-19.

Out hope is to ensure that community offices are able to continue to safely see patients through this public health emergency.

Question Title

* 1. Which forms of PPE do you have a critical supply of (less than 1 week)?

Surgical/procedure mask

Isolation gown

Gloves

Eye protection (goggles or face shield)

Question Title

* 2. Please provide your practice address so that we can follow-up with you.

Name

Office Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number