Supply Request Form

Quantity	Tubes
	10 ml Plain red top (no gel)
	10 ml SST (gel separator)
	4.5 ml Light blue top (CITRATE)
	5 ml Gray top (FLUORIDE)
	5 ml Lavender top (EDTA)
	7 ml Dark blue top
	8.5 ml yellow top
Quantity	Cytology/Pathology
	Pap Smear Kit (1 slide)
	Pap Smear Kit (thin prep)
	Sure Path
	Cyto Scraper / Brush
Quantity	Forms
	Supply requisition forms
	Laboratory Requisition forms
Quantity	Specimen Collection
	Blood Culture Bottles/tubes
	Culturettes
	Non-sterile 4 oz container
	Ova & Parasite kit
	Probetec swab (GC & Chlamydia)
	Serum Transport tube
	Stool container 4 oz
Quantity	Urine containers
	24 hr- Boric acid
	24 hr- Hydrochloric acid
	24 hr- Sodium Hydroxine
	24 hr-No additive
	Sterile 4 oz Urine cup
Quantity	Needles
	21 Gauge x1 (multi sample)
	22 Gauge x1 (multi sample)
Quantity	Misc. Supplies
	Plastic bio-hazard bags
	Tourniquets
	Vacutainer needle holder (reg)
	Lock Box