Mask/Test Request Form

Please fill out this request form if you're in need of masks or Covid-19 rapid tests. Mask Up Pittsburgh offers delivery and pickup around Pittsburgh, PA. We will contact you if we have questions or need additional information. Once a request is fulfilled, we will delete your information to ensure as much privacy as possible.

Masks and tests are available for everyone, including individuals, households, groups, and even events. You are welcome to request more than once if you need masks or tests in the future.

Event Guidelines: This form is only open for event requests the 1st-5th of the month. If your event is before the 10th of the month please submit your request a month in advance to ensure we have the time to fill it. There are a maximum of 300 masks available each month for events. Tests will be available based on supply and on a case by case basis. If you are planning your event weeks to months in advance please consider adding tests/masks to your budget. We can work with you to find legitimate masks, the best deals, etc. Events may not request covid-19 tests if the event does not require masks.

If you have any questions or need additional assistance, contact us at: maskuppgh@protonmail.com

What is your name? (Real or fake name is fine.)*

How can we contact you? We prefer email, but phone numbers are acceptable. We will typically text any questions or drop-off notifications.*

What types of masks do you need? Note: Not all types may be available at all times, but we will do our best to provide the type you prefer. N95s have headstraps, KN95s and KF94s have earloop straps.If you need masks for children, please let us know the age range so we can provide the recommended mask size (or let us know if you already know it).

How many people require masks and how many of each kind?Ex: My household has three people who need masks, two need KN95 tri-fold adult masks and one needs a child-sized (approx 10 years old) kn95 mask.

YesNo

How many people need Covid-19 tests?

Pick UpDrop Off

Please provide a full address, including zip code, if you are requesting a drop off. We typically provide contact-free drop off. Please let us know where to put the masks/tests upon arrival.

This is a space to provide us with any other information we may need, or any access information. Accessible information, such as the presence of stairs or steep inclines is essential to our volunteers delivering your tests/masks safely. EVENT ORGANIZERS: PLEASE LET US KNOW WHEN YOU NEED MASKS/TESTS BY. WE LIKELY HAVE NOT BEEN MADE AWARE OF YOUR EVENT PREVIOUSLY AND WILL NEED THIS INFORMATION TO ENSURE YOU GET MASKS/TESTS ON TIME.

MUP Mask/Test Request Form