Surgical Mask Request Form

The masks are are intended for general practices and pharmacies in areas where there are shortages and stocks are unavailable commercially.

As there is a limited supply, a default allocation of 50 masks will be sent per request. If a larger allocation is required, please provide additional information to support the request in the comments section of the form.

If you are unable to see the Surgical Mask Request Form, please click here.


Beckwith Park, 30 Tanunda Road Nuriootpa SA 5355
PO Box 868 Nuriootpa SA 5355
T 08 8565 8900 F 08 8311 1723
E This email address is being protected from spambots. You need JavaScript enabled to view it.





While the Australian Government Department of Health has contributed to the funding of this website, the information on this website does not necessarily reflect the views of the Australian Government and is not advice that is provided, or information that is endorsed, by the Australian Government. The Australian Government is not responsible in negligence or otherwise for any injury, loss or damage however arising from the use of or reliance on the information provided on this website.

Country SA PHN gratefully acknowledge the financial and other support from the Australian Government Department of Health