Mask and Test Request Form

Mask and Test Request Form | Indy Mask Bloc
Please read before filling out this form:
- We distribute free masks/respirators, rapid COVID tests, and other airborne precaution supplies/resources primarily in the Central Indianapolis area.
- We primarily provide contactless delivery. If this is unsuitable for you, please let us know.
- For digital safety, responses to this form are encrypted. We also delete sensitive information such as contact info, names, and addresses on all requests once they are fulfilled.
- Please allow at least 7 days for us to fulfil your request, as we are a small group of volunteers with limited capacity.
- You can email us at indymaskbloc@proton.me with any additional inquiries.
If you are located outside of Indiana(polis), please refer to the COVID Advocacy Map (clickable link) to find mask blocs and other COVID action groups in your area.

If you are located within Indiana but outside of our driving radius, and/or if you have no active mask blocs closer to you, we can mail you the supplies you need.

As a mask bloc, our primary focus is practicing community care rooted in disability justice during the ongoing airborne pandemic(s). With this in mind, we have very limited capacity to fulfill requests for in-person events. We can however, share information and lower cost resources to help mitigate airborne transmission risk at in-person events. Please reach out to us if this interests you, and thank you for understanding.

Need floor air purifiers for an upcoming in-person event? Reach out to Indy Clean Air Fans (clickable link)
If you are located outside of Indiana, please refer to the COVID Advocacy Map (clickable link) to find mask blocs and other COVID action groups in your area.

If you are located within Indiana but outside of our drop off radius, and/or if you have no active mask blocs closer to you, we can mail you the supplies you need.

As a mask bloc, our primary focus is practicing community care rooted in disability justice during the ongoing airborne pandemic(s). With this in mind, we have very limited capacity to fulfill requests for in-person events. We can however, share information and lower cost resources to help mitigate risk at in-person events. Please reach out to us if this interests you, and thank you for understanding.
Please provide an email or phone number (SMS text) for us to contact you:*
IndividualHousehold
How many adults are going to be using the supplies you're requesting?*
If requesting children's' masks, please list the ages of the children
so we can do our best to give the correct sizes
We provide KN95, N95, and KF94 respirators, as they are the easiest high filtration masks to acquire in bulk.

We currently have the following styles to distribute:
- Duckbill with headstraps
- Boat-style/tri-fold with headstraps or earloops (kid-sized included)
- Bi-fold with headstraps or earloops (kid-sized included)
- Cup/cone style with headstraps
See images below for reference, but they do not represent our entire stock.
Duckbills with headstrapsKids boat-style/tri-fold with earloopsKids bi-fold with earloopsAdult boat-style/tri-fold with earloopsAdult boat-style/tri-fold with headstrapsAdult bi-fold with earloopsAdult bi-fold with headstrapsCup/cone style with headstrapsNo preference (give me a mix of adult size styles)None of the above/I want a specific brand
If the options above do not suit your needs, please specify what brand/style of mask/respirator you want in the box below. We have some other options in smaller quantities that may be better suited for you. We cannot guarantee we will be able to fulfill your request, but we are working to expand our inventory. *
Adjustable earloopsEarsaversThicker strapsAdult with a smaller faceAdult with a rounder faceChild with a smaller faceChild with a rounder faceOther
If you have a color preference, feel free to indicate that in the box below. Most of our stock is black or white, but we have some colorful options. We cannot guarantee we will be able to honor your preference, but if we have what you want, we're happy to get it to you.
YesNo
YesNo
We are currently distributing the Genabio brand of Rapid Antigen Tests, which expire 3/1/2026 (March 1st 2026). Here's a picture for reference:
We are currently all out of rapid COVID tests and are in the process of restocking.
YesNo
Very urgent use: I/we are currently having symptoms, OR have been exposed to COVID and need to test as soon as possibleSemi-urgent use: I/we might have been exposed to COVID and want to test to rule it outNon-urgent use: I/we expect exposure to COVID soon and want tests on hand to prepareNon-urgent use: I/we haven't been exposed to COVID and/or don't expect any exposure to COVID soon, but want to have tests on hand just in caseOther
Here are the educational materials we share with requesters:
- Tips for wearing and reusing your masks
- Tips to get more accurate results with Rapid Antigen Tests
- Long COVID essentials
- Guide to using expired masks
- How to add adjustable earloop beads
- Other resources for COVID safety
Digital/soft copyDigital/soft copy (screen-reader compatible format)Paper/hard copy (limited supply)
Pick upDrop off
Please provide the name and address you would like your supplies mailed to. If you have an assigned resident mailbox, make sure the name provided matches the name on your mailbox to prevent the package being sent back.*
Please specify what location you would like to meet at for pick up. You could also provide your neighborhood or a nearby landmark, and we will do our best to coordinate a pick up location to meet you. *
Please provide the address where you would like your supplies dropped off. Please make sure to include any additional delivery instructions that may be needed (apartment number, gate code, etc).*
Questions, Comments, Security/Access Needs
Questions, Comments, Security/Access Needs
Do you own a storefront or are you part of an organization that wants to/already does provide community care? Are you interested in providing free masks/respirators for the community, at much reduced cost to you? If yes, please provide the name of your organization and an email address for us to contact you. We look forward to collaborating and sharing resources. Thanks!
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Mask and Test Request Form | Indy Mask Bloc