Please confirm Email Address*
Primary Phone (111-111-1111)*
Number of Business Locations in Harris County
Please choose one option for the loss in revenue post COVID-19 (Since March 1, 2020)
Did you apply and receive funding from any of the recently approved Harris County Programs to assist Small Business Assistance?
Was your business impacted significantly by state or local COVID-19 executive order closure requirements? (i.e. Have you changed the primary focus of your business?) Please describe.
Women and/or Minority Owned Business
Please indciate the number of items you are requesting below.
Thermometer (Maximum of 2)
Please enter your email address above to receive a copy of your submission. You must bring it with you (printed or digital)
to pick up the PPE’s from your selected County Precinct on the date, time and location to be determined.
For a digital copy and/or to print: please click HERE before you hit the submit button. Then print or save as pdf.
For more information or assistance, please send an email to BusPPEReq@pur.hctx.net or call 713-274-4400.