• Company / Organization and Contact Information

      If you are a legitimate source for medical supplies, please fill out the form below to register as a supplier and sell your products.

    • Please ensure this is the complete company name, including Inc., LLC, etc.
    • Product Supply Information

      Identify the type of supplies and quantities you can provide or make that meets the CDPH specifications (PDF).

    • From the list above, please provide more details on each item selected. Click the " + " icon to add a new row for each item.
      Type of Supplies (selected above)QuantityEst. Unit Cost (USD)Initial Ship Date 
    • Resource

    • N95 Masks
    • KN95 Masks
    • Surgical Masks
    • Isolation Gowns / Suits
    • Nitrile Exam Gloves
    • Facial Shields
    • Ventilators - Invasive
    • Ventilators - Non Invasive
    • IV Drip Apparatus
    • Sanitary Wipes
    • Infrared Thermometers
    • COVID-19 Test Kits
    • Quantity

    • Est. Unit Cost (USD)

    • Initial Ship Date

    • Product Information

    • For disinfectants and other chemical products, including hand sanitizer.
    • For masks and other PPE.
    • Drop files here or
      Accepted file types: pdf, jpg, png.
      FDA/EPA/CDC/NIOSH documents, price sheets, product specifications, product images. Maximum 10 files. 10 MB limit. Allowed types: pdf jpg png.
    • Payment Terms / Location / Delivery Information

    • Please enter the country your inventory is located in.
    • Please indicate if this is either a payment or donation.
    • Please share any additional information as-needed.