Personal Protective Equipment Survey

For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

Need for personal protective equipment

Need for personal protective equipment - Question identifier:1.

Does this business need or expect to need personal protective equipment to operate in accordance with COVID-19 related public health guidance?

  • : Yes
  • : No
  • : Don't know
    Please specify the reason for not knowing whether personal protective equipment is needed to operate in accordance with COVID-19 related public health guidance i.e. not knowing the COVID-19 related public health guidelines, not knowing when employees will return to work on site.

Employee Information

Employee Information - Question identifier:2.

On March 1, 2020 how many employees did this business have?
Include all employees who received a T4.
Exclude business owners, contract workers and other personnel who will not receive a T4.
Employees

Employee Information - Question identifier:3.

For the month of January 2022, how many employees did this business have?
If unable to provide exact values, please provide your best estimate.

  • : Total number of employees
  • : Number of full-time employees
    i.e. works 30 hours or more a week

Employee Information - Question identifier:4a.

What is the number of employees working onsite and offsite for the following months?
Offsite employees include those who are teleworking.

  • : Onsite
    January 2022
    February 2022
    March 2022
    April 2022
    May 2022 onwards
  • : Offsite
    January 2022
    February 2022
    March 2022
    April 2022
    May 2022 onwards

COVID-19 Rapid Testing

COVID-19 Rapid Test kits are self-testing kits that are used to assess and monitor the infection status of individuals with or without symptoms. Typically such kits provide a result within 15 minutes and can be used by employers to screen for COVID-19 among employees in settings where in-person work is required. Positive test results typically require confirmation by more accurate laboratory-based tests administered by public health authorities.

COVID-19 Rapid Testing - Question identifier:4b.

You indicated you have employees working on site. For January 2022, has this business used COVID-19 Rapid Test kits to test on-site employees for COVID-19 infection?
e.g., periodic testing of employees with or without symptoms

  • : Yes
    For January 2022, what percentage of this business' on-site employees was tested using a COVID-19 Rapid Test kit at least once?
    %
    OR
    Don't know
  • : No
    In the next three months, does this business plan to use COVID-19 Rapid Test kits to test on-site employees for COVID-19 infection?
    Yes
    No
    Don't know
  • : Not applicable to this business

COVID-19 Rapid Testing - Question identifier:4c.

For January 2022, on average, how frequently were employees at this business tested using COVID-19 Rapid Test kits?

  • : Less than once a week
  • : Once a week
  • : Twice a week
  • : More than twice a week

COVID-19 Rapid Testing - Question identifier:4d.

In the next three months, does this business plan to use COVID-19 Rapid Test kits to test on-site employees for COVID-19 infection?

  • : Yes
  • : No
  • : Don't know

COVID-19 Rapid Testing - Question identifier:4e.

For which of the following reasons does this business not have plans to use COVID-19 Rapid Test kits in the next three months?
Select all that apply.

  • : Lack of awareness
  • : Difficulty procuring
  • : Cost of tests
  • : Cost of administering tests
  • : Low perceived risk (e.g., high vaccination rates, PPE use, etc.)
  • : Not needed
  • : Other
    Specify other:

Essential personal protective equipment and supplies

Essential personal protective equipment and supplies - Question identifier:5a.

For the personal protective equipment and other supplies listed below, please indicate which are essential to this business' operations and if you expect a shortage in the next 3 months.
A shortage means the business is unable to obtain sufficient supplies for its needs.

  • : COVID-19 Rapid Test kits
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Nitrile Gloves
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Non-medical Gloves (i.e. vinyl gloves, plastic gloves)
    Essentiel to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Hand Sanitizer
    Essentiel to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Face Shields
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Disposable Gowns
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Reusable Gowns
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Respirators (i.e. N95, KN95 Masks)
    Essentiel to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Surgical Masks
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know
  • : Non-medical Masks (i.e. cloth masks, reusable masks)
    Essential to business
    Yes
    No
    Shortages within next 3 months
    Yes
    No
    Don't know

Essential personal protective equipment and supplies - Question identifier:5b.

You identified that the following personal protective equipment and supplies were essential for your business' operations. Please fill out the corresponding information to the best of your knowledge.

  • a.: COVID-19 Rapid Test kits
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • b.: Nitrile Gloves
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • c.: Non-medical Gloves (i.e., vinyl gloves, plastic gloves)
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • d.: Hand Sanitizer
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • e.: Face Shields
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • f.: Disposable Gowns
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • g.: Reusable Gowns
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • h.: Respirators (e.g., N95, KN95 Masks)
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • i.: Surgical Masks
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know
  • j.: Non-medical Masks (i.e., cloth masks, reusable masks)
    How has your business' need for this PPE changed compared to before the COVID-19 pandemic?
    Was not needed before
    Significantly higher need
    Somewhat higher need
    About the same need
    Somewhat lower need
    Significantly lower need
    Do you anticipate that your business will continue to need this PPE after the COVID-19 pandemic has concluded?
    Yes
    No
    Don't know

Essential personal protective equipment and supplies - Question identifier:5c.

You identified that respirators were essential to this business' operation. Does your business conduct fit tests for the N95 or equivalent masks it requires?
Fit tests are for each individual employee who requires an N95 or equivalent mask to ensure that it perfectly fits their face shape to provide complete protection against aerosols or particulates.

  • : Yes
  • : No

Essential personal protective equipment and supplies - Question identifier:5d.

You indicated an expected shortage for the following personal protective equipment and supplies. What is the main reason for the expected shortage?

  • : COVID-19 Rapid Test kits
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Nitrile Gloves
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Non-medical Gloves (i.e., vinyl gloves, plastic gloves)
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Hand Sanitizer
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Face Shields
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Disposable Gowns
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Reusable Gowns
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Respirators (e.g., N95, KN95 Masks)
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Surgical Masks
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other
  • : Non-medical Masks (i.e., cloth masks, reusable masks)
    Reason
    No supplier identified
    Delay in receipt of PPE from suppliers
    Insufficient products/equipment available from suppliers
    Insufficient purchasing power to buy quantities of PPE needed to secure suppliers
    Other

Consumption and procurement of personal protective equipment and supplies

For the following question, please report quantities in the unit of measure specified for each product.

Consumption and procurement of personal protective equipment and supplies - Question identifier:6a.

For the following personal protective equipment and other supplies essential to this business, indicate the inventory quantities, consumption and procurement amounts.
Report in the units of measure requested. If exact values are not known, please provide your best estimate.
Procurement: refers to personal protective equipment and other supplies you have purchased and received, excluding orders that have not arrived.

  • : Nitrile Gloves
    Unit of measure: Pairs
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Non-medical Gloves (i.e. vinyl gloves, plastic gloves)
    Unit of measure: Pairs
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Hand Sanitizer
    Unit of measure: Litres
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Face Shields
    Unit of measure: Individual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Disposable Gowns
    Unit of measure: Individual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Reusable Gowns
    Unit of measure: Individual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Respirators (i.e. N95, KN95 Masks)
    Unit of measure: Individual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Surgical Masks
    Unit of measure: Indivudual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards
  • : Non-medical Masks (i.e. cloth masks, reusable masks)
    Unit of measure: Individual Units
    Current Inventory quantity
    Estimated consumption/usage in January 2022
    Expected procurement in February 2022
    Expected procurement in March 2022
    Expected procurement in April 2022
    Expected monthly procurement for May 2022 onwards

Consumption and procurement of personal protective equipment and supplies - Question identifier:6b.

Where does this business or organization get or plan to get its personal protective equipment or supplies from?
e.g., masks, eye protection, face shields, gloves, gowns, cleaning products, disinfecting wipes, hand sanitizer, plexiglass or sneeze guards, thermometers
Select all that apply.

  • : Domestic producer
  • : International producer
  • : Domestic wholesaler
  • : International wholesaler
  • : Domestic retailer
  • : International retailer
  • : Other
    Please specify:

Consumption and procurement of personal protective equipment and supplies - Question identifier:6c.

Which 3 factors are most important to this business' purchasing decisions for PPE?

  • : Product is manufactured domestically
  • : Quality of product
  • : Product has official certification (e.g. NIOSH or FFP)
  • : Price
  • : Delivery times
  • : Environmental sustainability
  • : Product reusability
  • : Other
    Please specify

Manufacturing and distribution of personal protective equipment and supplies

Manufacturing and distribution of personal protective equipment and supplies - Question identifier:7.

Is this business involved in the manufacturing or distribution of personal protective equipment and other supplies for resale?

  • : Manufacturing
  • : Distribution
  • : Manufacturing and distribution
  • : No

Manufacturing and distribution of personal protective equipment and supplies - Question identifier:8.

Do you expect this business to continue to manufacture personal protective equipment 12 months from now?

Yes
No

For the following question, please report quantities in the unit of measure specified for each product.

Manufacturing and distribution of personal protective equipment and supplies - Question identifier:9.

Which of the following medical-grade products did this business manufacture in Canada for the purposes of commercial sale in January 2022?

  • : Nitrile Gloves
    Unit of measure: Pairs
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Non-medical Gloves(i.e. vinyl gloves, plastic gloves)
    Unit of measure: Pairs
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Hand Sanitizer
    Unit of measure: Litres
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Face Shields
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Disposable Gowns
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Reusable Gowns
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Respirators (i.e. N95, KN95 Masks
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Surgical Masks
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?
  • : Non-medical Masks (i.e. cloth masks, re-usable masks)
    Unit of measure: Individual Units
    Which products were manufactured?
    Annual maximum manufacturing capacity
    Estimated total quantity manufactured in January 2022
    Which products does this business plan to manufacture in 12 months?

Manufacturing and distribution of personal protective equipment and supplies - Question identifier:10.

Please report the 3 most significant obstacles this business has encountered manufacturing PPE:

  • : Lack of demand or customers
  • : Lack of capital or funding opportunities
  • : Difficulty sourcing inputs or raw materials
  • : Difficulty sourcing equipment
  • : Competition with lower-priced imports
  • : Other
    Please specify
    OR
    Did not experience any difficulty in manufacturing PPE
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