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Please note, we are currently only able to deal with requests from UK-based organisations.

Name

Organisation

Organisation Type (e.g. GP Surgery, Pharmacist, Care Home etc)

What PPE do you currently have?

Number of Face Shields Required

If you would you like any ear savers – How many?

Do you just need replacement visors (rather than full kits) ? How many?

Email Address

Phone Number

Address line 1

Address line 2

Town or city

County

Postcode

Extra Comments

By submitting this request you accept that you are requesting a kit which DOES NOT carry a CE mark, and cannot be used by healthcare professionals who require CE marked PPE.

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The data on this form will be used in relation to your request. We will store the fact that you have submitted your request and your contact details, but we will not send you any information beyond that which relates to your request, nor will we use the data for any other purpose.

The University of Warwick is the data controller of any information you have entered on this form and as such is committed to protecting your data and rights in line with applicable data protection law (including the UK GDPR and the Data Protection Act 2018). Please review the privacy information (including privacy notices) provided by the University via the following link, for further information on your rights and how the University processes your personal data: Data Protection.

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