(address)

I am an:

individual

organization* and I need help with...

individual

organization* and I want to help with...

Face Masks Face Shields Gloves Surgical Gowns Pharmacy Delivery Grocery Delivery Grocery Donation Dog Walking Wellness Check Sewing 3D Printing other:

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Organization Name

Number of people in your org.:

Contact Info

Add'l Info

What else should people know? Specific requirements? Do you have, or think you might have, COVID-19? Are you in a vulnerable group (60+, etc.)? Unique capabilities? Materials on hand? Hours available? Specific requirements? Do you have, or think you might have, COVID-19? Are you in a vulnerable group (60+, etc.)? Requirements, such as specific types of masks/shields accepted? Drop-off procedures? Unique capabilities? Materials on hand? Hours available? Unique capabilities? Supplies/materials on hand?

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* "organization" here means any institution (such as hospital), company, group of people, etc.