Health Office Nursing Supplies Request
* Required
SCHOOL
*
ELEMENTARY SCHOOLS AND HIGH SCHOOL ACADEMIES
PS# 1
PS# 2
PS# 3
PS# 4
PS# 5
PS # 6 & APA
PS#7
PS#8
PS #9
PS# 10
PS# 11
PS# 12
PS# 13
PS# 14
PS# 15
PS# 18
PS# 19
PS# 20
PS# 21
PS# 24
PS# 25
PS# 26
PS# 27
PS# 28
PS# 29
MLK
ALEXANDER HAMILTON ACADEMY
DALE AVE SCHOOL
DON BOSCO TECH.
EARLY LEARNING CENTER
EDWARD W. KILPATRICK
NEW ROBERTO CLEMENTE
NORMAN S. WEIR
ROBERTO CLEMENTE
URBAN LEADERSHIP ACADEMY
EASTSIDE HIGH SCHOOL;
GREAT FALLS ACADEMY
HARP
INTERNATIONAL HIGH SCHOOL / GARRETT MORGAN
JOHN F. KENNEDY HIGH SCHOOL
SPOSRT & BUSINESS - DESTINY ACADEMY
PANTHER ACADEMY
ROSA PARKS HIGH SCHOOL
SILK CITY ACADEMY
YES ACADEMY
STARS ACADEMY
This is a required question
NURSE NAME
*
This is a required question
ANTICEPTIC WIPE/SWAB
*
10 PER PACK
NONE AT THIS TIME
1 PACK
2 PACKS
3 PACKS
This is a required question
APPLICATORS 6" (COTTON TIP)
*
1000 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
This is a required question
APPLICATORS 6" (PLAIN)
*
1000 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
This is a required question
BAND AIDS -REGULAR
*
SIZE 1"X3" 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
6 TO 10 BOXES 1 CASE
1 TO 2 CASES
This is a required question
BAND AIDS - EXTRA LARGE
*
SIZE 2"X4 1/2 " 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
6 TO 10 BOXES 1 CASE
1 TO 2 CASES
This is a required question
BAND AIDS - BUTTERFLY CLOSURES
*
STRIPS 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
6 TO 10 BOXES 1 CASE
1 TO 2 CASES
This is a required question
BAND AIDS - KNUCKLE
*
SIZE 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
6 TO 10 BOXES 1 CASE
1 TO 2 CASES
This is a required question
BAND AIDS - FINGER TIP
*
SIZE 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
6 TO 10 BOXES 1 CASE
1 TO 2 CASES
This is a required question
COMFORTING 1 " STRETCH BANDAGES
*
1" NON-STERILE 12 PER BAG/BOX
NONE AT THIS TIME
1 BAG
2 BAGS
3BAGS
6 BAGS
This is a required question
COMFORTING 2" STRETCH BANDAGES
*
2" NON-STERILE 12 PER BAG/BOX
NONE AT THIS TIME
1 BAG
2 BAGS
3 BAGS
4 BAGS
5 BAGS
This is a required question
COMFORTING 3 " STRETCH BANDAGES
*
3" NON-STERILE 12 PER BAG/BOX
NONE AT THIS TIME
1 BAG
2 BAGS
3 BAGS
4 BAGS
5 BAGS
This is a required question
COMFORTING 6" STRETCH BANDAGES
*
6" NON-STERILE 12 PER BAG/BOX
NONE AT THIS TIME
1 BAG
2 BAGS
3 BAGS
4 BAGS
5 BAGS
This is a required question
COTTON BALLS
*
200 PER BAG
NONE AT THIS TIME
1 BAG
2 BAGS
3 BAGS
4 BAGS
5 BAGS
This is a required question
CUPS - DRINKING
*
5 OZ CUPS - 100 PER SLEEVE
NONE AT THIS TIME
1 SLEEVE
2 SLEEVES
3 SLEEVES
4 SLEEVES
5 SLEEVES
This is a required question
CUPS - MEDICINE
*
100 PER SLEEVE
NONE AT THIS TIME
1 SLEEVE
2 SLEEVES
3 SLEEVES
4 SLEEVES
5 SLEEVES
This is a required question
EYE CUPS PLASTIC
*
10 PER BOX - STERILE
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
This is a required question
EYE PADS
*
50 PER BOX - STERILE
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
This is a required question
EYE WASH
*
NONE AT THIS TIME
1 BOTTLE
2 BOTTLE
3 BOTTLE
4 BOTTLE
5 BOTTLE
This is a required question
2X2 GAUZE SPONGE NON-STERILE
*
100 PER PACK
NONE AT THIS TIME
1 PACK
2 PACKS
3 PACKS
4 PACKS
5 PACKS
6 PACKS
This is a required question
3X3 GAUZE SPONGE NON-STERILE
*
100 PER PACK
NONE AT THIS TIME
1 PACK
2 PACKS
3 PACKS
4 PACKS
5 PACKS
6 PACKS
This is a required question
4X4 GAUZE SPONGE NON-STERILE
*
100 PER PACK
NONE AT THIS TIME
1 PACK
2 PACKS
3 PACKS
4 PACKS
5 PACKS
6 PACKS
This is a required question
GLOVES-LARGE SYNTHETIC NITRILE BLUE
*
100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
This is a required question
GLOVES- MEDIUM SYNTHETIC NITRILE BLUE
*
100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
5 BOXES
6 BOXES
This is a required question
ICE PACKS: INSTANT
*
DISPOSABLE- INDIVIDUAL
NONE AT THIS TIME
1 TO 3 ICE PACKS
4 TO 6 ICE PACKS
6 TO 12 = HALF TO FULL CASE
1 CASE (10) PER CASE
2 CASES
This is a required question
ICE PACKS: SMALL
*
SIZE REUSABLE (BLUE)
NONE AT THIS TIME
1 TO 3 ICE PACKS
4 TO 6 ICE PACKS
6 TO 12 = HALF TO FULL CASE
1 CASE (10) PER CASE
2 CASES
This is a required question
ICE PACKS: LARGE
*
SIZE REUSABLE (BLUE)
NONE AT THIS TIME
1 TO 3 ICE PACKS
4 TO 6 ICE PACKS
6 TO 12 = HALF TO FULL CASE
1 CASE (10) PER CASE
2 CASES
This is a required question
LYSOL DISINFECTANT SPRAY
*
19. OZ CAN
NONE AT THIS TIME
1 CAN
2 CANS
This is a required question
PURELL HAND SANITIZER
*
12 OZ PUMP BOTTLE
NONE AT THIS TIME
1 BOTTLE
2 BOTTLES
This is a required question
SANITARY PADS BY CASE
*
NONE AT THIS TIME
1 CASE
2 CASES
Option 3
This is a required question
SANITARY PADS
*
# QUANTITY NEEDED IN THE BOX BELLOW {FOR LESS 250}
This is a required question
SUNDRIES: ALCOHOL
*
BOTTLE 16 OZ BOTTLE
NONE AT THIS TIME
1 BOTTLE
2 BOTTLE
3 BOTTLE
4 BOTTLE
6 BOTTLE
Option 6
This is a required question
SUNDRIES: ANBESOL
*
BENZOCAINE 10% ORAL ANESTHETIC 0.33 OZ (9G)
NONE AT THIS TIME
1 TUBE
2 TUBES
3 TUBES
4 TUBES
6 TUBES
12 TUBES
This is a required question
SUNDRIES: CALAMINE
*
LOTION 4OZ BOTTLE
NONE AT THIS TIME
1 BOTTLE
2 BOTTLE
3 BOTTLE
4 BOTTLE
6 BOTTLE
Option 6
This is a required question
SUNDRIES: FIRST AID
*
ANTICEPTIC & BURN CREAM (43GRAMS)
NONE AT THIS TIME
1 TUBE
2 TUBES
3 TUBES
4 TUBES
6 TUBES
Option 6
This is a required question
SUNDRIES: GREEN SOAP
*
16 OUNCES (1 PINT) BOTTLE
NONE AT THIS TIME
1 BOTTLE
2 BOTTLE
3 BOTTLE
4 BOTTLE
6 BOTTLE
Option 6
This is a required question
SUNDRIES: VASELINE
*
WHITE PETROLEUM JELLY 16.8 OZ TUBE
NONE AT THIS TIME
1 TUBE
2 TUBE
3 TUBE
4 TUBE
6 TUBE
Option 6
This is a required question
TAPE 1" MICROPORE
*
HYPOALLERGENIC SURGICAL TAPE
NONE AT THIS TIME
1 ROLL
6 ROLLS
12 ROLLS = 1 CASE
This is a required question
TAPE 1" ZONAS POROUS
*
NON STERILIZED - FABRIC SURGICAL
NONE AT THIS TIME
1 ROLL
6 ROLLS
12 ROLLS = 1 CASE
This is a required question
TELFA PADS
*
BOX OF 100
NONE AT THIS TIME
1 BOX
2 BOXES
This is a required question
THERMOMETER COVERS DIGITAL
*
PROBE COVERS 100 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
6 BOXES
Option 6
This is a required question
THERMOMETER COVERS THERMOSCAN
*
WELCH ALLYN PROBE COVERS 200 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
4 BOXES
6 BOXES
Option 6
This is a required question
TISSUES
*
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
6 BOXES
12 BOXES/ ONE CASE
This is a required question
TONGUE DEPRESSORS 6"
*
LATEX FREE 500 PER BOX
NONE AT THIS TIME
1 BOX
2 BOXES
3 BOXES
This is a required question
TRIANGULAR BANDAGES (NON STERILE)
*
INDIVIDUAL
NONE AT THIS TIME
1 BANDAGE
3 BANDAGES
6 BANDAGES
12 BANDAGES
This is a required question
ZIP LOCK BAGS
*
100 PER PACK
NONE AT THIS TIME
1 BAG
3 BAGS
6 BAGS
10 BAGS = 1 CASE
This is a required question
HEALTH OFFICE NURSING SUPPLIES
THE FOLLOWING SECTION WILL ALLOW YOU TO WRITE ANY NURSING SUPPLIES OR EQUIPMENT NEEDED IN YOUR OFFICE.
OTHER: NURSING SUPPLIES NOT LISTED
This is a required question
OTHER: EQUIPMENT
This is a required question
OTHER: FORMS
This is a required question
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