Idea Lab PPE Request Form
The Idea Lab at Baldwin Public Library and Polyflex are working with the community to produce vital PPE for those organizations in need. Use this form to request face shields. The donated Adjustable Reusable Face Shields are made of PETG and HDPE, Can be cleaned with 1:10 Bleach solution with 10 minute dry time.
 Adjustable Reusable Face Shields
Your Name (First and Last) *
Email Address *
Phone number *
Your Profession *
What company or organization do you represent? *
How many face shields do you require? Orders of less then 128 Porch pick only in commerce MI- unless to FIRE, EMS, or POLICE. *
Where is your facility located? (Full address please) *
Delivery or Pick up from Commerce,. MI ? *
If you have other questions or comments, please leave them below. We will reach out to you via email or phone with in 24 hours.
H.R.6201 - Families First Coronavirus Response Act (Sec. 6005) This section extends targeted liability protection to certain manufacturers, distributors, prescribers, and users of approved respiratory protective devices that are (1) subject to specified emergency use authorizations; and (2) used during the period beginning on January 27, 2020, and ending on October 1, 2024. (Emergency use authorizations allow for the use of unapproved drugs, biological products, or devices, or for the unapproved use of such products, to respond to a declared emergency.)If you are distributing this product to others it is your sole responsibility to convey to them that this product is NOT TESTED and NOT APPROVED by any regulatory body. *
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Denne formular blev oprettet inden for Baldwin Public Library. Rapportér misbrug