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Fill out the form below to submit your request for Personal Protective Equipment (PPE). You can also download a printable version of this form by clicking the button below and emailing your completed form to mdh.charlescountycccaresppe@maryland.gov. 

ITEM
AVAILABLE SUPPLY
REQUESTED NO.
Hand Sanitizer (10-12 oz)
Hand Sanitizer (Gallon Refill)
Hand Sanitizer Dispenser Stand
Med Approved N95 (35/box)
N95 (5/pack)
KN95 (10/box)
Surgical Mask (50/box)
Washable Mask (Youth, Adult)
Face Shield/Goggles (10/pack)
Gloves M/L (100 per box)
Disinfectant Wipes (80/pack)
Disinfectant Spray (gallon)
Gowns/Lab Coat (10/pack)
Hair Covers (100/pack)
Shoe Covers (100/pack)
Thermometers (1/box)
Pulse Ox (1/box)
Blood Pressure Cuffs w/wo Gauge (1/pack)
Stethoscope (1/pack)
Air Freshener (12/case)
Toilet Seat Cover (250/pack)