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  • PPE Supply Request Form

    for TCMS Members
  • We are requesting PPE from the state. We cannot guarantee quantities or availability for items. If there is a delay, or out of stock items, we will notify you before your scheduled pickup time.

  •  If you have multiple locations, please complete a form for each location.

    After you submit your order, we will send an email confirming receipt along with additional information for supply pick up.

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  • Supplies Requested

  • We are continuously receiving supplies.

    Please indicate how many items you need for 1 day and we will do our best to provide enough for 1-2 weeks. 

    Four N95 masks will be provided for each practitioner so that you can reuse them as outlined in the best practices section below.

  • Should be Empty: