New Customer: Receive quote on all selected items. Contacted within 1 business day

Current Customer: Order entered. Comfirmation of receipt within 1 business day

COMPANY:		ACCT#:
BILL TO ADDRESS:		CITY:
STATE:		ZIP:
SHIP TO ADDRESS:		CITY:
STATE:		ZIP:
PHONE:		FAX:
EMAIL:		CONTACT:

IV START KITS

QTY	PRODUCT	DESCRIPTION
	IV-175	Tegaderm/Alcohol
	IV-175C	Tegaderm/PDI Chlorascrub
	IV-175SN	Opsite/Alcohol

DRESSING CHANGE W/CHLORAPREP

QTY	PRODUCT	DESCRIPTION
	DC-5070C	Tegaderm/Chloraprep Triple/CSR
	DC-5070STKC	Tegaderm/Chloraprep Triple/Stacked
	DC-5073C	Tegaderm/Chloraprep 3ml One Step/CSR
	DC-5073STKC	Tegaderm/Chloraprep 3ml One Step/Stacked

DRESSING CHANGE W/ALCOHOL

QTY	PRODUCT	DESCRIPTION
	DC-180	Tegaderm/CSR/Acetone Alcohol swab (3)pk
	DC-5070	Tegaderm/Alcohol/CSR
	DC-5070STK	Tegaderm/Alcohol/Stacked
	DC-3050	Corium/Alcohol/PVP swab(3)/CSR
	DC-5070SN	Opsite/CSR/Alcohol/PVP swab(3)pk

DRESSING CHANGE PICC/VAD ACCESS/DECUBITIS

QTY	PRODUCT	DESCRIPTION
	DC-610SN	PICC Line Dressing Chg w/Opsite/CSR
	DC-680	VAD Access/CSR/Heparin flush/Na Cl 0.9%
	DC-850SN	PICC/Midline Cath Insertion Kit/Opsite/CSR
	DC-1505	Decubitus Tray/scissors/FCP/drape
	DC-1530	Decubitus Tray/scissors/FCP/drape/basin
	DC-3073	Decubitus scissors/FCP/ drape/Proxide/gauze str
	BE-100	Wound Measuring Device

DEBRIDEMENT/SUTURE & STAPLE REMOVER KITS

QTY	PRODUCT	DESCRIPTION
	SR-140B	Debridement Kit
	SR-205A	Debridement Kit
	SR-2A5B	Debridement Kit
	SR-255A	Debridement Kit
	SR-1000	Suture Removal Kit
	SR-1010	Suture Removal Kit
	SR-2000A	Staple Removal Kit

TRACHEOSTOMY TRAYS

QTY	PRODUCT	DESCRIPTION
	3018	Trach Care Tray/2 comp tray
	3032	Trach Care Tray/Basin/FCP
	3036	Trach Care Tray/3 comp tray

FOLEY/URETHRAL TRAYS

QTY	PRODUCT	DESCRIPTION
	3205	10cc Pre-Fill--BZK
	3206	10cc Pre-Fill--PVP
	3207	30cc Pre-Fill--BZK
	3208	30cc Pre-Fill--PVP
	3209	14FR Plastic--PVP
	3210	14FR Rubber--PVP

CATHETER INSERTION TRAYS

QTY	PRODUCT	DESCRIPTION
	CI-1000	Catheter Insertion 80/cs
	3201	Catheter Insertion 30/cs
	34004	Suction catheter 14 FR
	33066	Drainage Bag 16FR
	33068	Drainage Bag 18FR

IRRIGATION TRAYS/SYRINGES

QTY	PRODUCT	DESCRIPTION
	3002	60cc Bulb Syringe
	3003	60cc Top Ring Syringe
	3004	Bulb Syringe
	3005	Top Ring Syringe
	3006	Flat Top Syringe
	2001	Enteral Kit--Ring Top Syringe, 500cc Bottle

PREFILLED STERILE SOLUTIONS

QTY	PRODUCT	DESCRIPTION
	30191	120cc Water (cup)
	30192	120cc Saline (cup)
	30195	100cc Water (jar)
	30296	100cc Saline (jar)
	30367	1 Ounce Saline (bottle)
	3026A	60cc Pre-Filled Saline Syringe (pouch)

STAFF PROTECTION/SPILL CLEAN UP/BIRD FLU

QTY	PRODUCT	DESCRIPTION
	UPK-100	Basic Universal Precaution Kit
	UPK-150	Standard universal Precaution Kit
	UPK-200	Deluxe Universal Precaution Kit
	UPC-237	Deluxe Spill Clean-Up Kit
	UPC-238	Basic Spill Clean-Up Kit
	UPC-575	Bird Flu Kit
	PPE-100	Universal Precaution (Group) Kit

ADMISSION KITS