Medical Kit Request Form

Rugby Oregon's ATC contract stipulates each team carry a fully stocked medical kit. Below you will find the required products and quantities required. Please indicate the quantity you need, if any, and submit. New teams will receive a fully stocked medical kit.

NOTE - If you submit quantity 1 we will give you a quantity of 1. For example, if the suggested quantity for pre-wrap is 6 and you order 1 we are going to give you 1 roll of pre-wrap and not 1 order of 6 rolls. Similarly if you order 1 bandaid, we are going to give you 1 bandaid and not 1 order of the suggested quantity of 40. Please order accordingly so we can accurately pack your orders. Thank you!

Team Name *

Your answer

Ace Wrap, 6" - Qty 2

Your answer

Alcohol Prep Pads - Qty 20

Your answer

Bandaids, 1" - Qty 40

Your answer

Bandaids, Knuckle - Qty 10

Your answer

Benzoin Tincture - Qty 10

Your answer

Biohazard Bag - Qty 1

Your answer

Cavicide, 8oz - Qty 1

Your answer

Clippers, fingernail - Qty 1

Your answer

Emergency Blanket - Qty 1

Your answer

Eye Wash - Qty 1

Your answer

Flex-wrap, roll - Qty 1

Your answer

Gauze Pads, 3x3, sterile - Qty 50

Your answer

Gloves, nitrile, powder-free, med - Qty 50

Your answer

Hand Sanitizer, 4 oz - Qty 1

Your answer

Heel and Lace Pads - Qty 25

Your answer

Hydrogen Peroxide, 8 oz - Qty 1

Your answer

Ice Bags, pull n pak roll - Qty 1

Your answer

Microshield Mask - Qty 5

Your answer

Moleskin, economy 2" - 20 feet

Your answer

Non-Adherent Pads, 3"x4" - Qty 20

Your answer

Nose Plugs - Qty 20

Your answer

Pen Light - Qty 1

Your answer

Q-tips, 3" - Qty 10

Your answer

Sam Splint - Qty 1

Your answer

Scissors, Lister Bandage 5.5"

Your answer

Skin Lube, tube - Qty 1

Your answer

Sling, economy - Qty 1

Your answer

Pre Wrap - Qty 6 rolls

Your answer

Tape - cotton, elastic cloth (center red line) - Qty 3 rolls

Your answer

Tape - Jaylastic Stretchy - Qty 10 rolls

Your answer

Tape - Athletic - Qty 20 rolls

Your answer

Tape Cutter - Qty 1

Your answer

Tuf-Skin, 4 oz spray - Qty 1

Your answer

Tweezers, slant tip - Qty 1

Your answer