JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RRT PPE Check-in
Please answer a few quick questions if your organization is no longer in need of PPE! The RRT keeps local health departments informed about the COVID-19 related needs of organizations that provide social services.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is the name of your organization?
Your answer
Did you receive PPE support from the RRT in the past year?
Yes
No
Not sure
Clear selection
Why do you no longer need PPE support?
Our staff no longer meets with clients.
Our staff are vaccinated against COVID-19.
Our organization's budget for PPE is sufficient.
We have reliable suppliers from whom we purchase PPE.
We have enough donated PPE.
Our clients or community have PPE of their own.
Other:
Which of the following areas does your organization work in? Check all that apply.
Healthcare Safety Net
Basic Needs
Disability Services
Childcare
Services for Aging/Older Adults
Information and Referral Services
Behavioral Health
Services for the Unhoused
Homelessness Prevention
Volunteer Coordination
Distance Learning and Technology Access
Food Insecurity
Education
Re-employment
Justice and Legal Supports
PPE Sourcing/Distribution
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Urbn Redux.
Report Abuse
Forms
