PPE Donation Form Thank you so much for your willingness to donate PPE to Minnesota's Community Health Centers! We appreciate you! Please complete the form below and someone from the MNACHC team will follow up with you. Question Title * 1. Contact Information Name Company City State Email Address Phone Number Question Title * 2. What type(s) of PPE do you have to donate? Gloves N95 Masks Surgical Masks Gowns Shoe Covers Hand Sanitizer Face Shields Other (please specify) Question Title * 3. How much PPE do you plan to donate (by type if more than one)? Question Title * 4. Anything else you would like to share with us about your donation? Done
