Sample Request Form

Thank you for your interest in Canada Masq. Please complete a quick survey to request your Procedure Mask samples.

First name

Last name

Company name

Position

Email

Phone

Address

1. What ASTM level of masks are currently used in your home? Example: ASTM Level 3.

2. What are the top 3 criteria you select to choose your mask? Example: quality, comfort, where they are made, price, etc.

3.Do you order Small (Paediatric) sizes for your staff members with small faces?

4. On average how many boxes of masks do you use per month?

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CAD $99 in CANADA & CAD $135 to USA
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