First Name
Last Name
Email
Postal Code
Facility Name
Facility Type Acute Care Ambulatory Surgery Center (ASC) Dialysis Other Alt. Site
Please identify your Equipment Manager:
Equipment Manufacturer
Type of Device Other (Specify in Comments)
Number of Devices
What surface disinfectant are you currently using?
PDI Product of Interest Super Sani-Cloth Wipe Sani-Cloth Prime Wipe Sani-Cloth Bleach Wipe Sani-Cloth AF3 Wipe Sani-Cloth Plus Wipe Easy Screen Cleaning Wipe Sani 24 Spray Sani-Hypercide Spray Sani-Cloth Prime Disinfectants Sani-24 Disinfectants Sani-Hypercide Disinfectants Sani-Hands Wipes Prevantics Skin Antisepsis Prevantics Device Swabs Profend Nasal Decolonization Kit
Comments
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