This order form is for organizations authorized by the California Department of Public Health (CDPH) to order Personal Protective Equipment (PPE) to protect farmworkers from respiratory viruses such as avian influenza (also known as bird flu) and COVID-19.

CDPH is supporting a one-time distribution of PPE for dairy farmworkers and others who handle raw milk, as well as slaughterhouse and poultry workers.

The PPE available for distribution includes respirators, gloves, bouffant caps, and safety goggles. Distributed PPE cannot be returned to CDPH.

Personal protective equipment can be used for many things, including to protect against respiratory viruses, to protect against COVID-19 and for point-of-care laboratory testing.

Additional Resources

Please refer to the following additional resources:

List of Available PPE

Brands and quantities available subject to change based on availability:
  • Respirators
    • Powered Air Purifying Respirator (PAPR) Kit
    • - Limited resource. Only local government entities may request PAPRs.
    • N95 masks
  • Nitrile powder-free gloves
  • Safety goggles
  • Face shields
  • Bouffant caps
  • - Limited inventory available.

Planning for your order

  • Eligible organizations (farms, businesses and organizations that serve dairy farmworkers, workers who handle raw milk, and slaughterhouse and poultry workers) may place a one-time order request for PPE.
  • Offered brands of PPE may change and requests for specific brands are subject to availability and cannot be guaranteed.
  • Email confirmations will be sent following submission and approval of orders.
  • Please allow 7-10 business days for delivery.

Please verify your order for accuracy before you submit.

Organization Information

Organization Point of Contact (Person Placing Order)

Delivery Point of Contact (Person Who Will Receive Shipment)

Delivery Information

Important: Please review and verify your address to avoid delays.

  • No P.O. Boxes; must be a street address
  • Must be in California
  • Delivery Point of Contact must be at the address to receive the shipment

PPE Order Request

Please enter amounts requested for each item below. Enter '0' if none requested.

Please verify your order for accuracy before you submit. Once approved, orders cannot be changed or corrected.

Additional comments or requests: