consumables order form
Post on 01-Apr-2016
216 Views
Preview:
DESCRIPTION
TRANSCRIPT
CERVICAL CYTOLOGY THINPREP CYTOLOGY AND/OR HPV TESTINGQTY DESCRIPTION QTY DESCRIPTION
(a) SlideContainers (i) SamplingVials(6pack)(b) GlassSlides(50perpack) (i) SamplingVials(25pack)
(c) EndocervicalBrush(100perpack) HISTOLOGY(d)Spatula-Plastic (j) HistologyContainers&ZipLockBags(e) CervicalSampler–BroomType(50perpack)(f) CervixBrushCombi(50perpack)(g) CytologyFixativeSpray(100ml)
QTY DISPOSABLE SPECULA(h) Small(25perpack)(h) Medium(25perpack)(h) Large(10perpack)image not shown
Email your order to: stores@vcs.org.au or fax: 03 9349 1977 This order form is available at http://www.vcs.org.au/practices/consumables.html
PLEASE INCLUDE YOUR PRACTICE NO. TO HELP PROCESS YOUR ORDER
VCS PRACTICE NUMBER: PHONE:
NAME:
ADDRESS:
POSTCODE:
PATHOLOGY REQUEST FORMS* & INFORMATION RESOURCESQTY PATHOLOGY REQUEST FORMS QTY INFORMATION RESOURCES
RequestForms (for computer printing) Paptestsandyou
RequestForms (manual with pre-printed practitioner details) - If details are different from above see over leaf
WhatifaPaptestresultisabnormalChlamydia-WhatisChlamydia
* Pathology request forms are suitable for all tests TakingaPaptestDVDTestingforChlamydiaDVDMailingPathologySpecimenstoVCSChlamydiaPoster(seeoverfordesigns)
Corp-Fin-F-1V9 Issued March 2014
(Print name)
Date:
Requested By: PTO for images of the consumables available.
VCS PATHOLOGY ABN35430554780
POBox178CarltonSouthVIC3053Phone:(03)92500300
CONSUMABLES ORDER FORM
TRANSPORTATION AND MAILING SUPPLIESQTY MAILER USE FOR
When ordering please consider
the most economical use of the mailing
supplies.
(n) SpecimenBioHazardBags(100perpack) >allspecimens(o) ReplyPaidEnvelopes >postingsingleslidestoVCS(p) TubeMailers >UriSWABs(q) PotMailers >HPV,ThinPrepandHistologysamples(r) ReplyPaidSatchel–CategoryB >singleormultiplesamples
CHLAMYDIA TESTINGQTY DESCRIPTION
(k) UriSWAB(ChlamydiaUrine)(10perpack)(l) FlockedSwab(Chlamydia)(10perpack)(m)Chlamydia&PapTestPack
VICTORIAN CYTOLOGY SERVICE
Reply Paid 178CARLTON SOUTH VIC 3053
BIOLOGICAL SUBSTANCES – CATEGORY B
PO Box 178 Carlton South VIC 3053
752 Swanston St, Carlton VIC 3053
Phone: 03 9250 0300
UN3373
MANUAL REQUEST FORMS (Provide details to be pre-printed on Manual Request Forms)
(a) Slide container (b) Glass slides (c) Endocervical Brush (d) Spatula - Plastic (e) Cervical Sampler Broom Type
(f) Cervix Brush Combi
(g) Cytology Fixative Spray (h) Disposable Specula (i) Thin Prep Sampling Vial (j) Histology Containers
CERVICAL CYTOLOGY, HISTOLOGY & HPV TESTING
(k) Uri SWAB (Chlamydia Urine)
(l) Flocked Swab (Chlamydia)
(m) Chlamydia & Pap Test Pack Contains slide & slide container, cervical sampler and flocked swab.
Chlamydia Posters
CHLAMYDIA TESTING
(n) Specimen Bag (o) Reply Paid Envelopes(post only)
(p) Tube Mailer (post only) (q) Pot Mailer (post only) (r) Reply Paid Satchel(post only)
TRANSPORTATION AND MAILING SUPPLIES
For detailed mailing instructions go to http://www.vcs.org.au/practices/mailing.html
VCS PRACTICE NUMBER: PHONE:
NAME:
ADDRESS:
POSTCODE:
A B C
CONSUMABLES ORDER FORM
VICTORIAN CYTOLOGY SERVICE
Reply Paid 178CARLTON SOUTH VIC 3053
BIOLOGICAL SUBSTANCES – CATEGORY B
PO Box 178 Carlton South VIC 3053
752 Swanston St, Carlton VIC 3053
Phone: 03 9250 0300
UN3373
top related