Medical Device Suppliers/Donors Registry

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This form is to gather information of suppliers, so that we can best provide linkage between supply and demand of the medical devices, PPE and tools needed at hospitals.Please take a few moments to fill the information below.

Thank you,

Students 4 COVID

Name of the supplier: *

Address: *

Point of contact Name and Title: *

Point of contact phone number: *

Point of Contact E-mail: *

Type of supplies you have access to, please list: *

Supplier Website (If available):

Supplier Twitter Handle (If available):

Supplier Instagram handle (If available):

Supplier Facebook page (If available):

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