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Request a Rendering!
Select the items below and add item quantities
to submit your order for management approval!
Revitalist Supplies Form
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*
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Name
*
First
Last
Email Address
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Date
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Please Select Your Location
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Bethesda
Chattanooga
Jacksonville
Johnson City
Knoxville
Louisville
Novi
Raleigh
SUPPLIES - REVITALIST
Normal Saline
0.45% Normal Saline
Lactated Ringers
Tubing
IV Start Supplies
Needles/IV Catheters
Patient Care Items
Personal Protection Equipment
Sterile Supplies
Tape
Syringes
Controlled Substances
Blood Pressure Drugs
Other Drugs
Vitamin Supplies
ACLS Drugs
Normal Saline
1000 mL
500 mL
250 mL
Size
1000 mL
500 mL
250 mL
0.45% Normal Saline
1000 mL
500 mL
Size
1000 mL
500 mL
Lactated Ringers
1000 mL
Size
1000 mL
Tubing
Flow Regulator
Roller Clamp
Accessory
Flow Regulator
Roller Clamp
IV Start Supplies
Tegaderm 2 3/8 x2 3/4
2x2 gauze sponge
Alcohol prep pads
Tegaderm (2 3/8 x2 3/4)
2x2 Gauze Sponge
Alcohol Prep Pads
Needles/IV Catheters
18 G
22 G
24 G
25 G
27 G
Size
18 G
50 needles per box
22 G
50 needles per box
24 G
50 needles per box
25 G
27 G
100 needles per box
Patient Care Items
Male Urinals
Under Pads
Emesis Basis
Urine Drug Screen
Pregnancy Test
Male Urinals
Under Pads
Emesis Basis
Urine Drug Screen
25 urine drug screen cups per box
Pregnancy Test
Nitrile Gloves
S
M
L
Size
S
100 / BOX
M
100 / BOX
L
100 / BOX
Personal Protection Equipment
Face Shield
Sharps Container
Face Shield
Sharps Container
Sterile Supplies
Small Sterile Gloves
Large Sterile Gloves
Sterile Drape 18x26
20 G Huber Needle Set
Chloraprep 2% Swab
Small Sterile Gloves
50 gloves per box
Large Sterile Gloves
50 gloves per box
Sterile Drape 18x26
50 per box
20 G - Huber Needle 20g set
25 sets per box
2% Chloraprep Swab
Tape
Clear Transpore Tape
Coban Wrap 2 in
Clear Transpore Tape
Coban Wrap - 2 in
Syringes
Monojet Tuberculin 1cc
Luer Lock 3cc
Luer Lock 10cc
Normal Saline Pre-filled 10cc
Monojet Tuberculin 1cc
Luer Lock 3cc
Luer Lock 10cc
NS Pre-filled 10cc
Controlled
Ketamine INJ
Versed INJ
Ketamine INJ
Versed INJ
Blood Pressure Drugs
Cardene INJ
Labetalol INJ
Metoprolol INJ
Hydralazine INJ
Clonidine PO
Cardene INJ
Labetalol INJ
Metoprolol INJ
Hydralazine INJ
Clonidine PO
Other Drugs
Zofran INJ
Zofran PO
Benadryl INJ
Decadron INJ
Toradol INJ
Zofran INJ
Zofran PO
Benadryl INJ
Decadron INJ
Toradol INJ
Vitamin Supplies
Asorbic Acid INJ
Glutathione INJ
Calcium Gluconate INJ
B-Complex INJ
Vitamin D3 INJ
Hydoxocobalamin INJ
NAD+ INJ
Zinc INJ
Magnesium Sulfate INJ
Pitocin INJ
Biotin
Asorbic Acid INJ
Glutathione INJ
Calcium Gluconate INJ
B-Complex INJ
Vitamin D3 INJ
Hydoxocobalamin INJ
NAD+ INJ
Zinc INJ
Magnesium Sulfate INJ
Pitocin INJ
Biotin
ACLS Drugs
Epinephrine INJ
Amiodarone INJ
Epinephrine INJ
Amiodarone INJ
Name
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