Standex Systems Ltd • 39 Charter Gate • Northampton • NN3 6QB • Phone: 01604 646 633 • Fax: 01604 644 646 • E-Mail: [email protected] www.standexsystems.co.uk Domiciliary Care Order Form RECORDS System No Quantity per 50 Quantity per 100 Your Order Quantity Admission 21.133 £21.50 £29.00 Support Plan 21.134 £43.45 £58.50 AM Visit Care Plan 21.135 £21.50 £29.00 Lunch Visit Care Plan 21.136 £21.50 £29.00 PM Visit Care Plan 21.137 £21.50 £29.00 Night Visit Care Plan 21.138 £21.50 £29.00 Care Plan Evaluation 21.054 £21.50 £29.00 Manual Handling 21.139 £21.50 £29.00 Personal Plan 21.140 £21.50 £29.00 Medication Record 21.141 £21.50 £29.00 Staff Sign Sheet 21.142 £21.50 £29.00 Financial Transaction 21.143 £21.50 £29.00 Daily Log 21.144 £21.50 £36.00 Support Network 21.060 £21.50 £29.00 Personal Care 21.065 £21.50 £29.00 Bowel Chart 21.066 £21.50 £29.00 Food Chart 21.067 £21.50 £29.00 Weight Chart 21.068 £21.50 £29.00 Body Chart 21.069 £21.50 £29.00 Falls Risk Assessment 21.074 £21.50 £29.00 MUST Tool 21.073 £21.50 £29.00 Pressure Ulcer Assessment 21.076 £21.50 £29.00 RECORDS Unit Price Your Order Quantity A4K £2.95 MSIPS £4.50 BM-4R £12.00 Total Cost for Files & Folders £ : Files & Folders Additional Items RECORDS Unit Price Your Order Quantity £ £ £ £ Total Cost for Additional Items £ : Total Cost of System ex Del & VAT £ : Forms RECORDS System No Quantity per 50 Quantity per 100 Your Order Quantity General Risk Assessment 21.079 £21.50 £29.00 Risk Assessment Evaluation 21.080 £21.50 £29.00 Communication Sheet 21.092 £21.50 £29.00 This is Me 21.293 £21.50 £29.00 Personal History 21.059 £21.50 £29.00 Mental Capacity Assessment 21.061 £21.50 £29.00 Lasting Power of Attorney 21.063 £21.50 £29.00 Consent 21.335 £21.50 £29.00 Future Wishes 21.064 £21.50 £29.00 Cornell Depression Scale 21.285 £21.50 £29.00 Depression Scale 21.083 £21.50 £29.00 Communication Sheet 21.092 £21.50 £29.00 Family Communication 21.095 £21.50 £29.00 Total Cost for Forms £ :