SUPPLIER ORDER FORM

Benefits & Services

Our Emergency Dental Kit

Designed from JADA recommendations
Affordable, Simple, Customizable
Trusted, Reliable, Professional Service
Auto-Replenishment Program (don't worry about expiration dates, let us do that worrying!)
Drug Recall Monitoring (no one wants to give faulty medications during an emergency!)
Complimentary Expiration Date Monitoring Program

Emergency Dental Kit Form

Supply Information

Dentist Information

Standard Adult Kit

Standard Pediatric Kit

Advanced Kit

Epinephrine Pen

Epinephrine Jr. Pen

Diphenhydramine Injectable

Diphenhydramine Chew Tabs

Glucose

Albuterol Inhaler

Nitroglycerin Tablets

Aspirin Tablets

Syringes

CPR Shield

Epinephrine Vial

(1)
(1)
Standard Adult Kit
Epinephrine Pen
Epinephrine Jr. Pen
Diphenhydramine Injectable
Diphenhydramine Liquid
Glucose
Albuterol Inhaler
Nitroglycerin Tablets
Aspirin Tablets
Syringes
CPR Shield
Epinephrine Vial (1)
Standard Pediatric Kit
Epinephrine Pen
Epinephrine Jr. Pen
Diphenhydramine Injectable
Diphenhydramine Liquid
Glucose
Albuterol Inhaler
Nitroglycerin Tablets
Aspirin Tablets
Syringes
CPR Shield
Epinephrine Vial (1)
Advanced Kit
Epinephrine Pen
Epinephrine Jr. Pen
Diphenhydramine Injectable
Diphenhydramine Liquid
Glucose
Albuterol Inhaler
Nitroglycerin Tablets
Aspirin Tablets
Syringes
CPR Shield
Epinephrine Vial
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