PPE Supply International

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Name *

First Name Last Name
E-mail *
Company *
Tell us about Your company *

Hospital or Medical Center Government Official Wholesaler Consumer Other
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Which Product ? *

3-ply Masks KN95 Masks N95 Masks Children's Masks Cotton Masks Hand Sanitizers Alcohol Spray Alcohol Wipes EPA Surface Wipes Nitrile Gloves Vinyl or Latex Gloves Face Shields Medical Gowns Air Purifiers Oximeters Digital Thermometers Ventilators Covid 19 testing kits
Area of Manufacture *

USA Canada / Mexico China Asia except China Europe Middle East Doesn't Matter
Quality *

FDA 510k CE Doesn't matter
Quantity *
Time frame to receive product *

ASAP Less than 1 month More than 1 month More than 3 months More than 6 months
Where in World will Product or Service be Used *

USA Canada Mexico Central / South America Europe Asia Middle East Africa Australia / New Zealand
Additional Information (Be as complete as possible with product names, model numbers, destination, target prices, etc. *
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