Pinellas: Donations needed from our business community to help fight COVID-19
RequiredRequired Question(s)
Due to COVID-19, Pinellas County is proactively collecting the following items for our hospitals, first responders, emergency medical services, nursing homes and home healthcare workers. Today, we're reaching out to our business community to ask for donations of only the items listed below.  

Please complete the survey below if you're able to donate, sell or manufacture these specific supplies to help at this time. 

Personal Protection Equipment (PPE) items requested:
Surgical Face Masks
P100 Masks
N95 Masks
Face Shields
Nitrile Exam Gloves, Powder Free
5 and 7 mil Nitrile Gloves
Eye protection - Safety Glasses
Surgical Tear Away Gowns
Safety Eye Goggles

Disinfectants requested :
Hand Sanitizer (any size) 60% Alcohol
91% Isopropyl Alcohol
Clorox Wipes
Lysol Disinfectant Spray
Sani-Cloth Wipes
3% Hydrogen Peroxide

Medical devices requested (New and unused only, please):
Ventilators - Hospital, Transport, Home Use - Invasive positive pressure ventilators that can be utilized for intubated patients
CPAP - Hospital, Disposable, Home Sleep Apnea
BiPAP/BiLevel - Hospital, Disposable, Home Sleep Apnea
High Flow Nasal Cannula Set-ups

 
Required 1.
Can you or your business donate, sell or manufacture any of the following items?

Personal Protection Equipment (PPE) items requested:
Surgical Face Masks
P100 Masks
N95 Masks
Face Shields
Nitrile Exam Gloves, Powder Free
5 and 7 mil Nitrile Gloves
Eye protection - Safety Glasses
Surgical Tear Away Gowns
Safety Eye Goggles

Disinfectants requested :
Hand Sanitizer (any size) 60% Alcohol
91% Isopropyl Alcohol
Clorox Wipes
Lysol Disinfectant Spray
Sani-Cloth Wipes
3% Hydrogen Peroxide

Medical devices requested (New and unused only, please):
Ventilators - Hospital, Transport, Home Use - Invasive positive pressure ventilators that can be utilized for intubated patients
CPAP - Hospital, Disposable, Home Sleep Apnea
BiPAP/BiLevel - Hospital, Disposable, Home Sleep Apnea
High Flow Nasal Cannula Set-ups

Donate
Sell
Manufacture for delivery. Please provide details in the comments section, below.
Other  
  • Comment:

  • 500 characters left.
2.
Please include your contact information below so that we can get in touch with you. Without this critical information our team cannot reach out to you to help our community. This information will only be used to communicate during our current COVID-19 crisis.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
Postal Code:

Required 3.

Pinellas County is under a Local State of Emergency. 

If you would prefer to speak with our team directly to donate or sell the items requested above, please contact Citizen Information Center (CIC) at (727) 464-4333 from 8 a.m. to 8 p.m. Monday through Friday; Saturday and Sunday from 10 a.m. - 2 p.m. Those with hearing impairment can chat online at www.bit.ly/PinellasChat

If you'd rather that Pinellas County contact you, please indicate your preference below, and enter your phone number or email address into the "comments" section.

Please, also ensure that you fill out your COMPLETE CONTACT INFORMATION in Question 2.


Phone
Text
Email
Other  
  • Comment:

  • 500 characters left.
4.

Is your business still open and operating?

Yes
No
Other  
  • Comment:

  • 500 characters left.
5.
If your business is still operating, which days of the week are you open? Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6.

What are your current hours of operations?

 

350 characters left.
7.
Do you have Nitrile Exam Gloves, Powder Free or 5 and 7 mil Nitrile Gloves to donate, sell or can you manufacture these? Please include the quantity and exact type of gloves you will donate or sell in the comments section.

If you do not have these types of gloves, do you have plans and the capability to manufacture them? Please include the exact type of gloves, quantity and the date these items would be available for delivery.  

DONATE: Nitrile Exam Gloves, Powder Free - See drop off locations and hours below. Please take your items directly to these locations.
DONATE: 5 and 7 mil Nitrile Gloves -See drop off locations and hours below. Please take your items directly to these locations.
SELL: Nitrile Exam Gloves, Powder Free
SELL: 5 and 7 mil Nitrile Gloves
MANUFACTURE: Nitrile Exam Gloves, Powder Free
MANUFACTURE: 5 and 7 mil Nitrile Gloves
If you can manufacture these items, please describe your capabilities in the comments section below. Most importantly, please include the date you could have the products ready for distribution and the quantities you can supply..
Other  
  • Comment:

  • 500 characters left.
8.
Do you have these items that you can donate, sell or manufacture?
- Surgical Face Masks
- P100 Masks
- N95 Masks
- Face Shields
- Safety Glasses
- Safety Goggles

Please include the quantity and exact type of personal protective equipment (PPE) you have currently available in the comments section.

If you do not have these types personal protective equipment (PPE), do you have plans and the capability to manufacture them?

Please include the exact type of PPE, quantities and the date these items would be available for delivery.  

DONATE: Surgical Face Masks - P100 Masks - N95 Masks - Face Shields - Safety Glasses - Safety Goggles. See drop off locations and hours below. Please take your items directly to these locations.
SELL: Surgical Face Masks - P100 Masks - N95 Masks - Face Shields - Safety Glasses - Safety Goggles
MANUFACTURE: Surgical Face Masks - P100 Masks - N95 Masks - Face Shields - Safety Glasses - Safety Goggles
If you can manufacture these items. Please describe your capabilities in the comments section below. Most importantly, please include the date you could have the products ready for distribution.
Other  
  • Comment:

  • 500 characters left.
9.
Do you have Surgical Tear Away Gowns that you can donate, sell or manufacture?

Please include the quantity of Surgical Tear Away Gowns you have currently available in the comments section.

If you do not have Surgical Tear Away Gowns, do you have plans and the capability to manufacture them?  Please include the quantities and the date these items would be available for delivery.  

DONATE: Surgical Tear Away Gowns | See drop off locations and hours below. Please take your items directly to these locations.
SELL: Surgical Tear Away Gowns
MANUFACTURE: Surgical Tear Away Gowns
If you can manufacture these items. Please describe your capabilities in the comments section below. Most importantly, please include the date you could have the products ready for distribution.
Other  
  • Comment:

  • 500 characters left.
10.
Do you have the Ventilators or Medical Devices listed below that you can donate, sell or manufacture?

Medical devices requested (New and unused only, please):
Ventilators - Hospital, Transport, Home Use - Invasive positive pressure ventilators that can be utilized for intubated patients
CPAP - Hospital, Disposable, Home Sleep Apnea
BiPAP/BiLevel - Hospital, Disposable, Home Sleep Apnea
High Flow Nasal Cannula Set-ups

Please specify type and quantity of Ventilators or Medical Devices you can offer in the comments section.

If you do not have these specific ventilators or medical devices, do you have plans and the capability to manufacture them?  Please include the quantities and the date these items would be available for delivery.  

DONATE: The type of Ventilators or Medical Devices listed above | See drop off locations and hours below. Please take your items directly to these locations.
SELL: The specific Ventilators or Medical Devices listed above
MANUFACTURE: The specific Ventilators or Medical Devices listed above
If you can manufacture these items. Please describe your capabilities in the comments section below. Most importantly, please include the date you could have the products ready for distribution.
Other  
  • Comment:

  • 500 characters left.
11.
Do you have these disinfectants that you can donate, sell or manufacture?
- Hand Sanitizer (any size) 60% Alcohol
- 91% Isopropyl Alcohol
- Clorox Wipes
- Lysol Disinfectant Spray
- Sani-Cloth Wipes
- 3% Hydrogen Peroxide

Please include the quantity and exact type of disinfectants you have currently available in the comments section.

If you do not have these types disinfectants, do you have plans and the capability to manufacture them?

Please include the exact type disinfectants, quantities and the date these items would be available for delivery.  

DONATE: Hand Sanitizer (any size) 60% Alcohol - 91% Isopropyl Alcohol - Clorox Wipes - Lysol Disinfectant Spray - Sani-Cloth Wipes - 3% Hydrogen Peroxide. | See drop off locations and hours below. Please take your items directly to these locations.
SELL: Hand Sanitizer (any size) 60% Alcohol - 91% Isopropyl Alcohol - Clorox Wipes - Lysol Disinfectant Spray - Sani-Cloth Wipes - 3% Hydrogen Peroxide
MANUFACTURE: Hand Sanitizer (any size) 60% Alcohol - 91% Isopropyl Alcohol - Clorox Wipes - Lysol Disinfectant Spray - Sani-Cloth Wipes - 3% Hydrogen Peroxide
If you can manufacture these disinfectants, please describe your capabilities in the comments section below. Most importantly, please include the date you could have the products ready for distribution.
Other  
  • Comment:

  • 500 characters left.
12.

Please select below the location to which you can deliver donations of the specific healthcare items listed above.  Social distancing will be practiced and personal protective equipment will be worn by our volunteers.  We do not want to put you or your staff at risk.

Hours of operations for donations:
- Wednesday, March 25, 10:00 a.m. - 7:00 p.m.
- Thursday, March 26, 10:00 a.m. - 7:00 p.m.
- Friday, March 27, 10:00 a.m. - 7:00 p.m.
- Saturday, March 28, 10:00 a.m. - 1:30 p.m.


If you have these items, please check the box below and proceed directly to your selected location (below) as soon as possible to donate medical supplies. 

If you have a very large quantity of these specific health care items that would be impossible to deliver, please select the "other" box below and add a description in the comments section.

North Pinellas: St. Ignatius Roman Catholic Church, 715 E Orange St., Tarpon Springs, 64689
Mid Pinellas: Walsingham Park, at 125th St. N. and 102nd Ave. N., Seminole, FL 33778
South Pinellas: Tropicana Field, Lot 4, 198 17th St. South, St. Petersburg, 33705
Other  
  • Comment:

  • 500 characters left.
13.

When can we expect health care supplies or donation?

Wednesday 3/25/20
Thursday 3/26/20
Friday 3/27/20
Saturday 3/28/20
Sunday 3/29/20
Monday 3/30/20
Tuesday 3/31/20
Wednesday 4/1/20
Thursday 4/2/20
Other  
  • Comment:

  • 500 characters left.
14.

What type of business do you operate?  This information will only be used to communicate during a crisis and improve our emergency supply chain processes. We're very grateful for your assistance. 

 

50 characters left.
15.

Are there additional medical items you'd like to donate at this time to assist our healthcare community?

 

350 characters left.