Alert

Lorem ipsum
Okay

NM Craft Responders Supplemental PPE Order Form

NM Craft Responders is a community of volunteer makers responding to COVID19 by making DIY facemasks and protective gear for healthcare workers and other frontline workers. Please note we are a small team and doing our best; we may not be able to fulfill all requests. Use this form to order masks or intubation boxes. Please reference this document in filling out your request: <https://airtable.com/shrwOTUq2F17Vomg1> Contact: craftresponders@gmail.com If we are unable to fulfill your request, please go to https://covidmaskcrafters.org/ *Please note that the information you provide here will be viewable by our team members. We will not share your information with 3rd-parties and will delete all contact info at the completion of this project. If we cannot fulfill your request right away, consider using the CDC recommended version of a No-Sew mask (D pattern): https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html THANK YOU FOR YOUR SERVICE and STAY SAFE!

Today's date.
Name of the contact placing request.
Best way to reach you
  • Email
  • Phone
Only enter a quantity here if it is not important what pattern of mask you receive or you do not know which pattern you require at this time.
Would you like to be contacted regarding the different mask options.
Sewn Fabric Mask - No Filter Pocket - Cloth Ties (N95 Cover)
Sewn Fabric Mask - Filter Pocket (filter not included) - Cloth Ties (N95 Cover)
Sewn Fabric Mask - Filter Pocket (filter not included) - Elastic Ear Loops
Sewn Fabric Mask - No Filter Pocket - Elastic Ear Loops
No Sew Mask - Distributed in kits including: Cloth, rubber bands, filter material, and instructions for simple assembly.
Intubation Boxes for use by Healthcare Workers. Acrylic boxes boxes that cover a patients face during the intubation process.
Pickup/Delivery
Either way, we will reach out to you to coordinate pick up/delivery location. Masks will be delivered clean and enclosed in a ziplock bag.
Who will be using the masks?
We are prioritizing healthcare workers, other essential workers, and at-risk communities at this time.
  • Healthcare workers
  • Frontline workers
  • General Public
  • Other

Do not submit passwords through Airtable forms. Report malicious form