Donations Form

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Donations Form

At this time Marin County is encouraging our public, business partners and organizations to donate select new and unopened personal protective equipment to assist our first responders and health care facilities who are responding to the COVID-19.

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Netfang *

First and Last Name *

Business or Organization Name

Phone Number *

Select any of the following items you would like to donate *

N95 masks (unopened boxes)

Surgical and/or isolation masks (unopened boxes)

Disposable gowns (unopened boxes)

Latex gloves (unopened boxes)

Fabric masks (new/unused)

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Please list any other medical supplies not listed above that you would like to donate

If you would like to donate any of the items above, please enter the quantity of those items below. *

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