ACAD EMR Supply Kit

ACAD EMR Supply Kit

Requisition Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Small Kit Contains:

1 - Pocket Mask

10 - Bandaids

6 - Sterile 4x4 Dressings

2 - 5x9 Sterile Dressings

2 -8x10 Sterile Dressings

2 - Roll Gauze

2 - Rolls Coban

2 - Triangular Bandages

1 - Roll of Tape

5 - Pairs of Gloves

Medium Kit Contains:

Same as small kit above but remove Pocket Mask and add:

1 - BVM

1 - Oral Airway Kit
Kit Requesting*

Small Kit (Pocket Mask - No BVM or Airways)Medium Kit (BVM & Oral Airways - No Pocket Mask)
Glove Size

MediumLargeExtra Large
We will contact you when your kit is ready for pickup. It will arrive in a gallon size plastic bag. Note: If you request the medium kit, the BVM may not fit inside the zip lock back.

Most kits will be ready very quickly, but may be delayed if we need to order supplies to fill. If you ever use a supply on a call, you can restock from the ambulance as long as it doesn't delay patient care.
Should be Empty: