San Francisco IHSS Public Authority

PPE Supply Sign-Up

Complete the form below to place an order to receive Personal Protection Equipment (PPE) from the San Francisco IHSS Public Authority:

* Choose glove size when you come to pick up your PPE.

Limited quantities or sizes will be offered as supplies last.
Only individuals who are actively receiving IHSS services or Providers who are working in San Francisco may order PPE from the Public Authority.
IHSS Recipients and Providers may only order supplies once a month; repeat orders will be denied.

First Name: Last Name:

Email Address: Phone Number:

Are you an IHSS Provider or Receiving IHSS Services?

IHSS Provider Receiving IHSS Services

Provider ID:

Your Provider ID number can be found on the IHSS paystub or on the e-timesheet portal.

Recipient Case ID:

Your Recipient Case ID number can be found on your notice of action or on the e-timesheet portal.

Choose the day you would like to come pick up your PPEs: