HEALTHSCOPE STORES ORDER FORM  
 
  VICTORIA  
  For use by Surgeries/Clinics serviced by the Victoria Pathology Stores Facility ONLY * mandatory entry fields

* Surgery/Clinic (ID please):
Comments/Requests:
*Your Name   Your Phone
*Your Email

 
 NEEDLES
Product
Code

U.O.M.

Qty.
    Holder Needle (Single Unit Barrel) Dispo 364815 (13438) PACK
    Needle Hypodermic 21gx38mm Green (Bx/100 302017 (33236) BOX
    Needle Hypodermic 23gx32mm Blue (Bx/100) 302008 (33239) BOX
    Needle Vacutainer 21g x 38mm Green Multi 360213 (33246) BOX
    Needle Vacutainer 22g x 38mm Black Multi 360211 (15172) BOX
 
 SYRINGES
Product
Code

U.O.M.

Qty.
    Syringe Luer Slip 10ml (Eccentric Tip) 302146 (33276) EACH
    Syringe Luer Slip 20ml (Eccentric Tip) 300613 (33282) EACH
    Syringe Luer Slip 5ml 302130 (33291) EACH
 
 SWABS / MEDIA
Product
Code

U.O.M.

Qty.
    Kit Female Endocervical Specimen Collect 441357 (27122) EACH
    Kit Male Urethral Specimen Collection fo 441358 (27123) EACH
    Kit Urine Preservative Transport for BD 441362. (27160) EACH
    Kit Vaginal Specimen Transport for BD Pr 441122 (27121) EACH
    Swab Plain Plastic Shaft in Tube 155CIS (15923) EACH
    Swab Skin Prep Alcohol 70% (Box/200) 12LC004 (48597) BOX
    Swab Skin Prep Water Sterile (Bx/50) 1021 (15932) BOX
    Swab Transport Amies Media 108CG (15924) EACH
 
 BLOOD TUBES
Product
Code

U.O.M.

Qty.
    Tube Sample Dark Blue 6ml TRCE/K2-EDTA 368381 (16236) EACH
    Tube Sample Gold 8.5ml SST II 367958 (16241) PACK
    Tube Sample Green 6ml LIHEP 367885 (16245) EACH
    Tube Sample Grey 5ml GLU 368201 (16248) PACK
    Tube Sample Lavender 2ml EDTA 367836 (16249) PACK
    Tube Sample Lavender 4ml EDTA 367839 (16250) PACK
    Tube Sample Light Blue 2.7ml CIT 363095 (16237) PACK
    Tube Sample Pink 6ml EDTA 367941 (16252) PACK
    Tube Sample Red 10ml Plain 367895 (16253) EACH
    Tube Sample Yellow 6ml ACD 367756 (16257) EACH
 
 HISTOLOGY/CYTOLOGY SUPPLIES
Product
Code

U.O.M.

Qty.
    Brush Cervix Rover Blue Pap Kit (Pk/50) 33023-RV (12610) PACKET
    Brush Cytology (Pk/10) 33009SA (12920) PACKET
    Cytology Fixative Spray (Healthscop Lbl) 400-200-6M (12921) EACH
    Histopot Formalin Filled 250ml HSP AHPHSP.250ML (20300) EACH
    Histopot Formalin Filled 70ml HSP (Pk/10 AHPHSP.70ML. (57306) PACK
    Kit Pap Collection Ayres (Red) 2133 33055GR (15849) KIT
    Kit Pap Collection Cervix (Black) 2134 33054GY (15850) KIT
    PreservCyt Solution 70098-002 (15463) VIAL
    Punch Biopsy Skin 2mm Disposable KAI-700 (12168) EACH
    Punch Biopsy Skin 3mm Disp BP-30F KAI-701 (12169) EACH
    Punch Biopsy Skin 4mm Disposable KAI-703 (12170) EACH
    Punch Biopsy Skin 5mm Disposable KAI-704 (12171) EACH
    Punch Biopsy Skin 6mm Disposable KAI-705 (12172) EACH
    Punch Biopsy Skin 8mm Disposable KAI-706 (12173) EACH
    Spatula Ayres Wooden (Pk/50) WCSP (12049) PACKET
    Speculum Vaginal Disposable Medium 33195MC. (53954) PACKET
    Speculum Vaginal Disposable Small 33194MC. (53953) PACKET
    Speculum Vaginal Large Ratchet Long Hand SPECRLHL (13091) EACH
 
 STATIONERY
Product
Code

U.O.M.

Qty.
    Doctor Stores Order Form SUNDRY006 (18623) EACH
    Form Path Request Pad Metro Blank 2 Part HSPVPAD0017 (16382) EACH
    Form Path Request Pad Regional Blank 2 P HSPVPAD0016 (39575) EACH
    Form Pathology Request Metro A4 Blank HSPVFRM0025 (16384) PACKET
    Form Pathology Request Metro A4 w/Labels HSPVFRM0023 (16385) PACKET
    Form Pathology Request Regional A4 Blank HSPVFRM0026 (38827) PACKET
    Form Pathology Request Regional A4 w/Lab HSPVFRM0024 (38840) PACKET
 
 CONTAINERS
Product
Code

U.O.M.

Qty.
    Bag Specimen Clear Healthscope (Pk/100) SB101HSCLEAR (20020) PACKET
    Bag Urinary Paediatric Urine Collector S PUCS100ML (15280) EACH
    Container Faeces 25ml Brown S/Cap HSP La 80.9924.017 (20296) BAG
    Container PP 70ml Yellow S/Cap (Bag/50) 75.9922.693 (20298) BAG
    Jerry Can 4ltr Red Cap HSP Labels & Bag JC4LNATSHR (20304) EACH
    Jerry Can 4ltr White Cap HSP Label & Bag JC4LNATSHW (20303) EACH
    Kit Faecal Occult VPZ-26 (22741) EACH
 
 MISCELLANEOUS
Product
Code

U.O.M.

Qty.
    Glucose Tolerance Drink 300ml 50g Clear GTD50/P (13301) BOTTLE
    Glucose Tolerance Drink 300ml 75g Clear FNNGTD/CLEAR (13302) BOTTLE
    Slide Mailer PP Clear Healthscope Logo MAILER-21. (22784) PACKET
    Slide Microscope Menzel Superfrost Bulk MENSF21201/100NC (51587) BOX
 
NOTE (1): ITEMS LISTED ARE APPROVED BY MEDICARE. PROHIBITED ITEMS WILL NOT BE SUPPLIED.
NOTE (2): MAXIMUM LIMITS APPLY ON ALL ITEMS. STOCK ORDERS WILL BE RELEASED APPROPRIATELY.

13/02/2008 Authorised by: National Logistics Manager, VIC STO-DRSORDFOR-003
54.145.39.186