Step 1 of 2 50% PPE Stock Order FormOrders need to be received by 12pm on the day before you wish to collect your stock. The hub coordinator will email you to confirm your order will be available and to clarify any items where needed. Please remember to bring a copy of your order and something to carry the PPE in when you collect. For details about hub opening times, please visit the intranet.Update: Monday 17 April 2023From Monday 17 April 2023 some items of PPE will no longer be available from the Government-funded, free-to-Trusts PPE service. Please refer to the order form for the latest items no longer available. These items will now need to be requested via the NHS Supply Chain (Integra), as per pre-COVID processes, and will no longer be supplied by the Stock Management team. All other PPE items, as per order form, should still be requested via the Stock Management team until otherwise indicated.Name * REQUIRED First Last Team the request is for * REQUIRED Team location * REQUIRED Contact telephone number * REQUIREDContact email address * REQUIRED Email address of colleague If you'd like a colleague to receive a copy of your order, please enter their email address above.We would like to * REQUIRED collect our order from a stock hub receive a drop delivery (deliveries are by pre-arrangement only) Select the hub you would like to collect from: * REQUIRED Cirencester Hospital Edward Jenner Court Lydney Hospital North Cotswolds Hospital Stroud Hospital Tewkesbury Hospital The Vale Hospital Wotton Lawn Hospital When would you like to collect? * REQUIREDDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Select a delivery location * REQUIRED Cheltenham Gloucester Forest of Dean Tewkesbury District Nurses Newent District Nurses North Cotswolds Which Cheltenham location? * REQUIREDCharlton Lane HospitalILCSpringbankSt Pauls - Laurel HouseSt Pauls - HoneybourneSt Pauls - Brownhill CentreSt Pauls DentalSt Pauls - Stanway CentreMilsom StreetLexham LodgeOtherWhich Gloucester ICT location? * REQUIREDBearlandsSouthgate MooringsStakes HayOtherWhich Forest of Dean location? * REQUIREDColliers CourtDean HouseOtherWhich North Cotswolds location? * REQUIREDGeorge Moore Community CentreGeorge Moore Community ClinicOther Please specifyDo you require your order to be split across different sites? If yes, please give details and quantitiesType IIR maskType IIR masks Price: Please specify how many items not boxesQuantityPlease enter a number greater than or equal to 0.Transparent Panel Type IIR masks Price: Please specify how many items not boxesHiddenQuantityPlease enter a number from 0 to 50.FFP3 masksPlease only order the type that you have passed a fit test on.3M 9330+ Price: Please specify how many items not boxesQuantity3M 1863+ Price: Please specify how many items not boxesQuantityPlease enter a number greater than or equal to 0.Alpha Solway 3030V (valved) Price: Please specify how many items not boxesQuantityAlpha Solway HX-3 Price: Please specify how many items not boxesQuantityHoneywell Price: Please specify how many items not boxesQuantityAlpha-Solway SS-3V Price: Please specify how many items not boxesQuantityMedicom Kolmi Regular Price: Please specify how many items not boxesQuantityMedicom Kolmi Small Price: Please specify how many items not boxesQuantityValmy Price: Please specify how many items not boxesQuantityGVS 31000 Price: Please specify how many items not boxesQuantityHandahny 9330 Price: Please specify how many items not boxesQuantityHandahny 9632 Price: Please specify how many items not boxesHiddenQuantityDrager Price: Please specify how many items not boxesQuantityOther Please specify type and quantityGownsLong sleeved gowns (Size M) Price: Please specify how many items not boxesQuantityLong sleeved gowns (Size L) Price: Please specify how many items not boxesQuantityLong sleeved gowns (Size XL) Price: Please specify how many items not boxesQuantityGlovesExtra small gloves Price: Please specify how many items not boxesExtra small gloves are no longer available from the stock team. Teams are requested to order direct from the NHS supply chain. QuantityExtra large gloves Price: Please specify how many items not boxesQuantityVisorsVisors Price: Please specify how many items not boxesQuantityAlcohol based hand rubHiddenQuantityHand rub (medium) Price: Please specify how many items not boxesQuantityHiddenWaste bagsHiddenQuantitySharps bins5-litre yellow sharps bin (with lid) Price: Requested as eachQuantityMiscellaneous consumablesCotton wool Price: Requested as bags of 200 ballsQuantityShoe covers (one size) Price: Requested as 100 pairs per bagQuantityOtherPlease give details of any items and quantities you want to order that are not listedDate Day Month Year CAPTCHA