First Aid First Kit Order Form – First Aid First

FIRST AID FIRST KIT ORDER

Client Details

Phone Number(Required)

Inspection Date(Required)

Officer’s Signature(Required)

Institution Name and Address

Street Address(Required)

Street Address Line 2

City

State / Province

Postal / Zip Code

Assessments

Standard First Aid kit Supplies

Small

Medium

Large

Notes

First Aid Guidance Leaflet – (Pack of 6)

First aid dressings Medium – (Pack of 12)

First aid dressings Large – (Pack of 12)

Finger dressings – (Pack of 12)

Eye dressings – (Pack of 6)

Burns dressings – (1 x 50 x 50 )

Washproof plasters – (100 x Assorted )

Conforming bandages – (Pack of 12)

Triangular bandages – (Pack of 6)

Face shields – (Pack of 5)

Sterile wipes – (Pack of 100)

Clothing cutters – (1 pair)

Foil blankets – (Pack of 6)

Microporous tape – (24×1.25cm x 10m)

Nitrile gloves pairs – (M x 100 pairs)

Safety pins – (36 x Assorted)

Kitchen First Aid Kits

Small

Medium

Large

Notes

Blue Plaster Tape(2.5cmx5m) – (Pack of 12)

Blue Finger Stalls – (Pack of 10)

Pairs of Blue Vinyl Gloves – (Pack of 100)

Blue Detectable Cohesive Bandage (5cm x 4.5m) – (1 roll)

Assorted Blue Detectable Plasters – (Assorted x 100)

Non-adherent-Wound Pads – (25 x Med 75×75)

Gauze Swabs – (100 x 75×75)

Sterile wipes – (Pack of 100)

Eye dressings – (Pack of 6)

White Open Weave Bandage – (6 x 7.5cmx5m)

Clothing cutters – (1 pair)

Safety pins – (36 x Assorted)

School First Aid kit Supplies

Small

Medium

Large

Notes

Eye wash pods – (20ml x 25)

Disposable gloves – (Medium x 100)

Burn dressings – (1x 50mm x 150mm)

Washprooof sterile plasters – (100 x Assorted )

Quick fix eye bandages – (Pack of 6)

Quick fix finger bandages – (Pack of 6)

Medium dressing – (Pack of 12)

Large dressing – (Pack of 12)

Moist wipes – (Pack of 100)

School Trip First Aid Kit

Small

Medium

Large

Notes

First Aid Guidance Leaflet – (Pack of 6)

First aid dressings Medium – (Pack of 12)

First aid dressings Large – (Pack of 12)

Eye dressings – (Pack of 6)

Washproof plasters – (100 x Assorted )

Triangular bandages – (Pack of 6)

Sterile wipes – (Pack of 100)

Clothing cutters – (91 pair)

Microporous tape – (24×1.25cm x 10m)

Nitrile gloves pairs – (M x 100 pairs)

Safety pins – (36 x Assorted)

Moist wipes – (Pack of 100)

Antiseptic Cream – (30g)

Forehead thermometer – (Pack of 10)

Cool gel sachets – (25 x 3.5g)

Travel sick bags – (Pack of 20)

Ice packs – (Pack of 20)

Empty nylon pouch – (1 pouch)

Other Findings & Comments

Inspection Agency Name (Required)

Agency Phone Number(Required)

Inspector’s Name (Required)

Inspector’s Signature(Required)