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Small Practice PPE Request Form

Thank you for your interest. Please press “Next” at the bottom of this page to begin completing the registration form.

Thank you for keeping your staff, patients, and NY residents safe from COVID-19. We wanted to share important updates regarding new opportunities to order personal protective equipment (PPE). Earlier this year, you were able to order pre-packaged PPE kits through participating distribution partners.

At this time, your small practice or independent pharmacy can order PPE directly from the NYC PPE Service Center to support organizational daily PPE need during the COVID-19 emergency, with some limitations. To apply for an account with the NYC PPE Service Center, please complete the registration form on the next page.

Once completed, your eligibility will be confirmed and an account will be created for your organization. Staff who will need access to the account should be listed in the contact section of the form. Staff will receive their account information (username and temporary password) in an email from Medline. For those who sign up for an account, additional information about placing orders will be sent and a training will also be held in a few weeks. Please be sure to check spam or junk mail folder. You will be notified if there are any issues in setting up the account. 

Once you receive your account information, you are encouraged to place your requests immediately on Medline.com. However, we want to make you aware of the following:
  • The requested products ordered need to be used during the NYS declared COVID-19 emergency (i.e., you must actively use the product within a 1-2 month period of ordering it).
  • Small quantities of the following PPE items will automatically show up in your shopping cart: isolation gowns, N95, masks/respirators, nitrile gloves, surgical masks, face shields, bouffant caps, boot covers, goggles, and hand sanitizer.
    • Note: Nitrile Gloves should only be ordered from the PPE Service Center if there is an emergency need at your facility.
  • You may order no more than once a month for your facility. It’s likely that even the smallest quantities available will last your practice a few months.
  • The City reserves the right to charge for-profit entities for the PPE they order, but exceptions will likely be made for small practices or independent pharmacies. PPE is priced at or below market rates.
  • All requests will continue to be subject to review and approval by NYC.
If you are having issues accessing your account, please reach out to nyccustomersupport@medline.com. If you have general questions about the PPE Service Center, please reach out to PPEsupport@health.nyc.gov.