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
- Date modified: