Humankind PCRS Services Order Form

Delivery Charge of £6.50 for all orders under £100. Orders placed before 1pm will qualify for next day delivery.

Please note, the submit button will appear at the bottom of the form once the minimum order value is reached.

Please confirm your Service and contact details before completing your order.

Name of Service

Address

Post Code

Contact Name

Telephone

Email Address

Product Code

Description

Box Qty

Qty Boxes

OMAC29

Acufine 1ml 29G Insulin Needle & Syringe - Identifiable

100

OMACLDS1

Acuject 1ml Low Dead Space Syringe

100

OMACLDS2

Acuject 2ml Low Dead Space Syringe

100

OMACON58

25g Orange Needles 5/8"

100

OMACON1

25g Orange Needles 1"

100

OMACBL1

23g Blue Needles 1"

100

OMACBL125

23g Blue Needles 1¼"

100

OMACGR15

21g Green Needles 1½"

100

OMNCAB

Citric Acid Sachets

1000

OMNVCB

Vit C Sachets

1000

OMNBSSF

Sterile Spoons with Filter

1000

OMAS

Alcohol Pre Injection Swab

100

OMPSR

Pasante Regular Condoms

144

OMPSL

Pasante TLC Lube 8ml Sachet

500

OMF5

Foil - Pack of 5 sheets

OMSLS(500)

SAFELOC™ One Single Use Sharps Container

500

OMSLS2

SAFELOC™ Two Single Use Sharps Container

250

OMN035

SAFELOC™ 0.35L Needle Exchange Bin

OMN050

SAFELOC™ 0.6L Needle Exchange Bin

OMBRW5

5ml Water for injection

100

Total Value: £

Plus VAT: £

Please tick to confirm that if you have ordered 2ml Water, 5ml Water, Prenoxad or Nyxoid you have obtained line manager approval

Yes

Please tick to confirm you have ordered sufficient 25ltr and 60 ltr sealed units for your needle exchange waste

Yes

Need help or advice?

Humankind PCRS Services Order Form

Please confirm your Service and contact details before completing your order.

Total Value: £

Plus VAT: £