Mask and Test Request Form--Mask Up Pittsburgh
Please fill out this mask 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 the request 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.

If you have any questions or need additional assistance, contact us at: maskuppittsburgh@gmail.com
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What is your name?
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Contact Information
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You are filling this form as a:
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Do you need masks?
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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. 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?
Do you need covid-19 tests?

*Note: tests may not always be available. If you request them and we have them, you will get them.
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How Many Covid-19 Tests Do You Need?
Would you prefer pickup or drop off?
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Please provide a full address, including zip code, if you are requesting a drop off.

Contact-free is available. Just 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 you may want to provide.
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