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Public Health Covid19 Supply Order

  1. *UPDATE* PPE DISTRIBUTION AT PLACER COUNTY PUBLIC HEALTH WAREHOUSE WILL END FOLLOWING THE APRIL 28 DISTRIBUTION DAY

  2. Please bring an appropriate vehicle for the size of the request. Trucks or SUVs are recommended when picking up PPE.

  3. Name of Facility

  4. Name of Requestor

  5. Supplies Requested*

  6. State supply availability changes weekly

  7. 20/box or 960/case

  8. 20/box or 120/case

  9. quantity requested

  10. 200 per box, smalls boxes.

  11. Smalls Limited Quantity Xtra Small only Latex available List quantity of each size requested

  12. Limited Supply

  13. 24/case

  14. Must send valid CLIA waiver to [email protected]

  15. Quantity Requested

  16. Quantity Requested

  17. If available, do you want your supplies sent to your location?*

    Depending on the size and availability of the order.

  18. *UPDATE* PPE DISTRIBUTION AT PLACER COUNTY PUBLIC HEALTH WAREHOUSE WILL END FOLLOWING THE APRIL 28 DISTRIBUTION DAY*

  19. To Procure PPE the State has set up a new website www.projectn95.org

  20. Leave This Blank:

  21. This field is not part of the form submission.