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Uniform Order Form
Uniform Order Form
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1
Your Details
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Ranges
3
Finalise
Name
*
First
Last
Facility
*
Select Facilty
Anderson Mill Nursing
Buckhead Nursing
Canton Nursing
Cartersville Nursing
Cherokee Nursing
Decatur Nursing
East Cobb Nursing
Empire/Corporate
Fayetteville Nursing
Fulton Nursing
Marietta Nursing
Powder Springs Nursing
Riverdale Nursing
Roswell Nursing
Sandy Springs Nursing
Westbury of Conyers
Westbury of Jackson
Westbury of Mcdonough
Winder Nursing
Woodstock Nursing
Department
*
Select Department
Activities
Administration
CMA
CNA
Dietary
Empire Experts
HSKP
Laundry
LPN
LPN Unit Manager
Rehab
RN
RN Unit Manager
Regional
Ranges
Your order:
CNA (Purple-Eggplant)
Purple-Eggplant Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Purple-Eggplant Shirt Quantity
Purple-Eggplant Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Purple-Eggplant Pant Quantity
LPN (Royal Blue)
Royal Blue Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Royal Blue Shirt Quantity
Royal Blue Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Royal Blue Pant Quantity
Dietary (Olive)
Olive Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Olive Shirt Quantity
Olive Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Olive Pant Quantity
Housekeeping & Laundry (Navy)
Navy Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Navy Shirt Quantity
Navy Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Navy Pant Quantity
REHAB (Burgundy)
Burgundy Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Burgundy Shirt Quantity
Burgundy Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Burgundy Pant Quantity
Activities (Lavender)
Lavender Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Lavender Shirt Quantity
Lavender Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Lavender Pant Quantity
Admin (Teal)
Teal Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Teal Shirt Quantity
Teal Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Teal Pant Quantity
CMA (CEIL BLUE)
CEIL BLUE Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
CEIL BLUE Shirt Quantity
CEIL BLUE Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
CEIL BLUE Pant Quantity
RN (Pewter)
Pewter Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Pewter Shirt Quantity
Pewter Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Pewter Pant Quantity
Expert (Black)
Black Shirt Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Black Shirt Quantity
Black Pant Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Black Pant Quantity
Lab Coat
Lab Coat Size
Select Size
XXS
XS
S
M
L
XL
2XL
3XL
4XL
5XL
Lab Coat Quantity
Your Details
Finalise Your Order
Quantity Quantity on
Is this order for a new employee?
*
Yes
No
Did you try on and confirm this is your size in this style?
*
Yes
No
Order notes (optional)
Notes about your order, e.g. special notes for delivery.
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