Submitted by Anonymous (not verified) on Sun, 03/22/2020 - 10:15 If you need help completing this form, contact response@gep.com Select Types: I Need Supplies I Can Supply I Can Manufacture ItemsQuantity N-95 respirator masks, all sizes (alternative manufacturers considered) Items Quantity Surgical masks with eye shields Items Quantity Safety goggles Items Quantity Patient ventilators Items Quantity Hospital-grade bleach wipes Items Quantity Hospital-grade peroxide wipes Items Quantity Latex-free gloves (all sizes) Items Quantity Fluid-resistant isolation gowns Items Quantity Hand sanitizer Items Quantity Hazmat suits Items Quantity Napkins Items Quantity Face masks Items Quantity Other Items Quantity ItemsQuantity N-95 respirator masks, all sizes (alternative manufacturers considered) Items Quantity Surgical masks with eye shields Items Quantity Safety goggles Items Quantity Patient ventilators Items Quantity Hospital-grade bleach wipes Items Quantity Hospital-grade peroxide wipes Items Quantity Latex-free gloves (all sizes) Items Quantity Fluid-resistant isolation gowns Items Quantity Hand sanitizer Items Quantity Hazmat suits Items Quantity Napkins Items Quantity Face masks Items Quantity Other Items Quantity ItemsQuantity N-95 respirator masks, all sizes (alternative manufacturers considered) Items Quantity Surgical masks with eye shields Items Quantity Safety goggles Items Quantity Patient ventilators Items Quantity Hospital-grade bleach wipes Items Quantity Hospital-grade peroxide wipes Items Quantity Latex-free gloves (all sizes) Items Quantity Fluid-resistant isolation gowns Items Quantity Hand sanitizer Items Quantity Hazmat suits Items Quantity Napkins Items Quantity Face masks Items Quantity Other Items Quantity donation_supply I would like to donate some / all of these items. donation_manufacture I would like to donate some / all of these items. What type of support do you need? Support repurposing my equipment and subject matter expertise Support with packaging and distribution Support with back-office functions (invoicing, PO creation, billing, etc.) Other: Please describe in one or two paragraphs the support you think you need. After submission, a member of our team will call you to obtain additional information: Please upload any photos that would help us with connecting you to the right subject matter experts to support (i.e. equipment photos, facility, etc.): Upload More informationFiles must be less than 8 MB. Allowed file types: gif jpg jpeg png bmp eps tif pict. Please provide Name: * Hospital/Organization Name: Company Name: Phone number * Email: * Address: * Supplier Certification Documents (Optional): Add a new file Upload More informationFiles must be less than 8 MB. Allowed file types: gif jpg jpeg png bmp eps tif pict txt rtf html odf pdf doc docx ppt pptx xls xlsx xml bz2 gz jar rar sit tar zip msg. Policy * . I have read and agree to GEP Terms & Conditions & Privacy Policy. Submit
