
Safe
Hands Program flyer (PDF format)
Order Form -- Safe Hands
Program
Other HITM website
documents
on hand washing
It is possible to purchase some of the above items
individually,
as follows.
___ (quantity) Video tape, English $65.00
each:
total _______
___ (quantity) Video tape, English /
Spanish
$95.00 each: total _______
___ (quantity) Safe hand washing poster (specify
English or Spanish) $3,75 each: total _______
___ (quantity) Anchor surgeon's brush $3.50
each: total _______
[CLOSE-OUT: 18" chains ($3.00 each) can be purchased separately
for fastening the
brush to the sink. ___ (quantity) 18" chains:
total _______]
___ (quantity) Glo-Germ kit $102.00
each:
total _______
___ (quantity) Certification lapel pins
(available
only to facilities that use our "Safe Hands" materials) $15.00 /
pack:
total _______
Name
____________________________________________________________
Phone____________________
Company
_________________________________________________________
FAX_____________________
Address
___________________________________________________________________________________
City, State, Zip-code
__________________________________________________________________________
___ enclosed is my total payment of $__________
___ please invoice me at the above address
___ pay by VISA / MasterCard
Card Number _______________________________________
Name on Card ______________________________________
Expiry Date ________________________________________
Other HITM
website
documents on hand washing
Click here
to find a section listing our
website
documents on hand washing.