Personal Protective Equipment (PPE) Needs Survey

The PPE Needs Survey is now closed. Thank you for your responses.

For more information about IDHS's coronavirus efforts, please see the IDHS Coronavirus Page

Organization:

Address:

City, State, ZIP:

Contact Name:

Email:

Phone:

Please specify the item count needed for each of the below:

* if reusing PPE per guidelines

Are there other items needed? If so, please write below, with quantities:

Please note the categories of employees that these items are needed for:

Please give a justification and explanation as to why these items are needed:
(e.g., in home care worker who enters 5 homes per day and must be in close
contact with the client in order to successfully perform job)