Clatsop County PPE Request Form

For MEDICAL PROVIDERS, BUSINESSES, AND COOPERATORS This process for ordering PPE replaces all previous methods made available to Medical Providers, Businesses and Cooperators that serve the residents of Clatsop County. To order, complete this form by 3 p.m. Monday each week that you wish to receive supplies. Every Wednesday, Emergency Management will begin weekly distribution to Medical Providers and Cooperators according to the directions provided in the request form. Please Note: If you are a Medical Provider or Cooperator with an URGENT supply need or have a question about the process, please contact Emergency Management at 503-325-8645. For businesses with the same needs, please contact your local Chamber directly. SUPPLIES ARE LIMITED Since there is a limited supply of PPE, availability of certain products may vary over time, and there may be instances where orders can only be partially filled due to current inventory. Certain supplies are only available to organizations that provide medical assistance such as clinics, medical providers and care facilities. HOW TO ORDER For planning purposes, we ask that organizations request only what is needed for a 1-week supply (using simple calculation method described below), however, an organization may submit a weekly request as often as needed. HOW TO DETERMINE 1-WEEK SUPPLY: Each day, throughout the week count the number of PPE items that were used or needed to maintain proper protection for your Clatsop County organization. At the end of the week, add all days together to determine your 1-WEEK BURN RATE. Thank you!

Requestor Information

The information you provide here will help us serve you better now and later: It helps us serve you better during the delivery process, and it helps us better understand the community needs so we can harness future opportunities to acquire additional resources in the future. (And we won't ever use your personal information for anything but processing your order.)

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Medical PPE

These items are only available to medical providers and other organizations that provide direct patient contact.

Order by the tub (75 wipes each)


Non-Medical PPE & Supplies

For Medical Providers, Businesses & Cooperators

Non-Contact Infrared Thermometer | 9V battery included

Disinfectant Supplies

For Medical Providers, Businesses & Cooperators

How many packages?

How many packages?

Use to refill your pump dispensers.

Use to refill or pump directly from the bottle.

Please provide any questions/comments to help us better serve you during this process.