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Personal Protective Equipment

PERSONAL PROTECTION EQUIPMENT NEEDS Questionnaire







    Primary Contact





    Secondary Contact





    How Did You Hear About Us?
    If you do not see the referral name below then please choose other and enter the same manually.



    Products I Please Include Size and Specs In The Description Box.
    If There is No Description Available, Please Write “N/A” in the Box.


    Surgical Masks


    Disinfectant Gel


    Face Shield


    Surgical Gloves


    Surgical Gowns


    Shoe Covers


    Disposable Bags


    Disinfectant Wipes


    Face Masks


    COVID-19 Test Kits


    3 Ply Masks


    Others


    Healthy Place has access to all major and most second tier PPE manufacturers.


    Does your organization have a specific brand preference? (leave blank if no preference)



    Additional Comments:




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