SCFRES
Supply Shortage Urgent Request Form
This form should only be used by entities within Suffolk County.
Entities within Nassau County should contact Nassau county OEM.
Please be aware that we use information shared between NYS and Suffolk County in evaluating and allocating PPE requests.

Contact

 

Secondary Contact

(Must Be A Different Person)

# Product Type Size (If Appl.) Quantity / # of Pieces
(Not cartons or boxes)
Quantity Used Per Week Quantity Currently On Hand
1
2
3
4
5