Call to action: Canadian manufacturers needed to help combat COVID-19

If you are a Canadian manufacturer or business that can assist Canada in meeting the need for medical supplies, your help is needed.

Please refer to the product specifications and requirements for Canada’s medical supply needs.

* indicates mandatory fields

Operational company name

Legal company name

Business number

Website

City

Province/Territory

Postal code

First name

Last Name

Contact phone number

Extension

Contact email address

How many of Personal Protective Equipment (PPE) items are you able to manufacture/sell/donate?

Item	Current Availability (Units/Per week)	Future Availability (Units/Per week)
Face Shields:
Safety goggles:
Surgical gowns:
N95 masks:
Surgical masks:
Vinyl gloves:
Nitrile gloves:
Other. Please specify name, current and future availability:

How many sanitation/cleaning products are you able to manufacture/sell/donate?

Item	Current Availability (Units/Per week)	Future Availability (Units/Per week)
Hand sanitizer - Liquid or Foam (Litre):
Disinfectant wipes:
Zip-lock bags:
Sanitation products:
Other. Please specify name, current and future availability:

How many medical equipment items are you able to manufacture/sell/donate?

Item	Current Availability (Units/Per week)	Future Availability (Units/Per week)
Swabs:
Test kits:
Thermometers:
Ventilators - ICU:
Ventilator accessories:
IV pumps and associated products:
Sterile equipment:
Other. Please specify name, current and future availability:

How many other general items are you able to manufacture/sell/donate?

Item	Current Availability (Units/Per week)	Future Availability (Units/Per week)
Beds or mattresses:
Linens:
Modular/temporary structures:
Barriers, shields, room dividers:
Other. Please specify name, current and future availability:

Specific to the production of alcohol for the purposes of sanitization and disinfectant, please indicate in the table below how much you can produce and/or how much you require for production of sanitization and disinfectant:

Item	Current Availability Units (Litre)/Per week	Future Availability Units (Litre)/Per week
Production of Alcohol:
Requirements for Production:

Start date for:

Production (DD/MM/YYYY): Delivery (DD/MM/YYYY):

Do you have manufacturing capacity that can be reoriented to help?
Reoriented manufacturing help - Other:

Excluding any supplies already identified, does your company have digital solutions that can help?
Digital solutions - Other:

Has your company previously sold goods to the Government of Canada?

How would you describe your business?
Describe Your Business - Other:

Additional Comments:

By submitting this form, I give permission to Innovation, Science and Economic Development Canada, on behalf of the company, to share the company name, contact information and capabilities listed in this form for the purposes of completing this work and for further analysis, with:

Other companies/organizations for potential collaboration opportunities
Other federal departments and/or Provincial government(s)
Federal Crown corporations.

I also give permission, on behalf of the company, to post the company name, product and contact information online.

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Call to action: Canadian manufacturers needed to help combat COVID-19