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Facility Name*
First Name*
Last Name*
Title
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Which securement device is your facility is using?*
Sample(s) to Request*
- CATH-SECURE Lock (5445-1)
- CATH-SECURE Original (5445-2)
- CATH-SECURE Extended Tab (5445-3)
- CATH-SECURE Dual Tab (5445-4)
- CATH-SECURE Plus (5445-6)
- NG-SECURE (9304-1)
- SHIELD-SECURE Face Shield (1010)
- CATH-SECURE For Kids (7334-2)
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