PPE (Personal Protective Equipment) Application for Institution or Groups

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Welcome to the Masks For Medics PPE application form. Please note that we are in the middle of our stocktake and recons so it may take us a bit longer to respond to you than usual. In the meantime, visit our Facebook page for further updates.

We are excited to assess your PPE needs and help keep you safe! Read below to continue completion of your application.

Please note:
*We can only supply to the Cape Metropole
* We supply PPE to home-based healthcare workers only. This includes old age and frail care facilities.
* We do not have a courier service and do not deliver
* If your application is approved, you will be asked to collect your pack at our collection point in Cape Town.

Siyavuya ukuhlola iimfuneko zenu ze-PPE sincede ukunikhusela!

Sicela niqaphele:
* Sinokubonelela kuphela kwisiXeko saseKapa (Cape Metropole)
* Sinikezela nge-PPE kubasebenzi bezempilo abasebenza ekhaya kuphela. Oku kubandakanya amaziko abantu abadala kunye namaziko okugcina ababuthathaka.
* Asinayo inkonzo yekhuriya kwaye asihambisi izixhobo.
* Ukuba isicelo senu samkelwe, niya kucelwa ukuba niqokelele ipakethi yenu kwindawo esiqokelele kuyo eKapa.

Email *

Has your institution already received a donation from MASKS FOR MEDICS?

Yes

Clear selection

Which Masks for Medics representative have you been in contact with? *

I have not been in contact with a representative from Masks For Medics

Dr Anthony Smith

Dr Julie Etellin

Dr Lauren Lee

Dr Sonia Hough

Dr Sarahan Brophy

Is your need for PPE in order to only treat hospital based patients? / Ngaba iimfuno zenu ze-PPE zezokunyanga abaguli abasezibhedlele kuphela? * *

Yes / Ewe

No / Hayi

If you answered "yes" to the above, please approach your hospital management directly to assist you in PPE procurement. Masks for Medics assists home-based healthcare care workers. / Ukuba niphendule ngokuthi "ewe" koku ngasentla, nceda niye kubaphathi benu besibhedlele ngqo ukuninceda ekuthengeni kwe-PPE. I-Masks for Medics inceda abasebenzi abakhathalela abaguli ekhaya.

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