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Maricopa County Ventilator Request
We understand this is an emergency request and we will respond to your inquiry as soon as it is processed. Thank you for your patience and understanding.
Please feel free to contact the Ventilator Team at (602) 359-1495 or at COVIDStaffing@Maricopa.gov if you have any questions or concerns.
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* Indicates required question
Facility Name
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Your answer
Type of Facility
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Your answer
Point of Contact (POC) Name
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Your answer
POC Phone Number
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Your answer
POC Email Address
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Your answer
Has it been confirmed there are no ventilators available from other locations in the requested facility's corporate system?
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It is highly recommended that you pursue this option prior to submitting a ventilator request through Maricopa County.
Yes
No
Other:
Number of ventilators currently in use in the requested facility
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Your answer
Total number of ventilators currently at requested facility
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Your answer
Requesting facility's current ventilator capacity
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Your answer
Number of ventilators being requested for the identified facility
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Please consider the number of trained personnel required to operate ventilators and the space required per unit when determining the number of requested ventilators.
Your answer
Is there any type of ventilator the requesting facility cannot accommodate?
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Your answer
Is there any any additional information that will provide a better understanding of the requesting facility's need for additional ventilators?
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Your answer
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