Face Shield Assembly Volunteer Intake Form
We are putting together NYU-style face shields (a full-facial coverage form of protection) for health care and other frontline workers here in the Bay Area. We are looking for dedicated volunteers who might be interested in helping assemble them in your very own home, as we have started to here in our Glen Park / Sunnyside neighborhood.  Would you be interested?

If this sounds exciting, we are preparing packs with materials to make between 50 to 100 face shields. These are made from light-weight plastic, use National Institute of Health-approved designs, take about 2 minutes to assemble, and so could be done all while watching a movie or hanging out after dinner. You'll need to have some basic hand dexterity to complete this project and between two to four hours.  Kids are welcome to participate but should have adult supervision.  

We have a lot of materials, so are asking if you can pick up and drop off at our central location, that's great. If not, we can look at other options of pickup/dropoff to your home.  And then presto! They come back to us, and we'll donate them out to frontline workers via the local chapter of GetUsPPE.org. Sounds good, yes?

We're asking assemblers to only take bags that they think they can complete within two days (48 hours). We ask that all volunteers wash hands before and after, and take any precautions possible to maintain a clean environment (mask-wearing, not volunteering if ill or exposed to sickness).

To donate or learn more, check out somethinglabs.org, and thanks!

Sign in to Google to save your progress. Learn more
One of the frontline workers at SF General Hospital using one of our Face Shields!
Name *
Email *
Phone Number (just for contact purposes) *
Can you pick up and drop off supplies in Glen Park, San Francisco? *
If you can't pick up and drop off, what address should we try to bring them to? (at this point, its fairly unlikely that we can do this but we're trying to solve for this, so we'll let you know!)
Are you able to help in any other ways, such as dropping off the shields at a facility near you or calling other facilities to see what their needs might be?  If so, please let us know the neighborhood you live in and what your interests are.  Thanks!
Statement Of Intent
We are volunteers making medical equipment to help save peoples' lives and support our frontline medical workers.  We intend to support them by creating these face shields in a clean, disease-free environment. As the demand for these far outstrips our supply, its important that if you volunteer to take these materials you can return them within 48 hours so we're able to stay as supplied as possible. Thank you so much for your interest and support.

Can you consent to having a clean and disease-free (to the best of your knowledge) environment for assembly?
Can you consent to taking bags only if you believe you can assemble them within 48 hours?
If you can agree, click below! *
Anything else we should know?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms