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PPE Order: August 2020

Please fill in quantity from the amount emailed to you.

Please be sure to complete address where we need to deliver.

Pricing includes tax and delivery.

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Personal Information

Name (First, Last)
Clinic Name
Street address


Hand Sanitizer (Case of 25) Quantity: Cost: $145.00
Masks (Case of 50) Quantity: Cost: $58.00
3M K95 (1) Quantity: Cost: $8.00
N95 (1) Quantity: Cost: $11.00
Face Shield (1) Quantity: Cost: $5.00
Gloves (100) Quantity: Cost: $13.00
Size for gloves 
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Expiration Date: (MM/YYYY)
Billing Address:
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APTA CT PO Box 459
Tolland, CT 06084
(857) 702-9915