UNIVERSITY OF NORTH CAROLINA WILMINGTON
SCHOOL OF NURSING
REQUEST FORM TO BORROW EQUIPMENT/TEACHING MATERIALS
Directions: Please complete this form for each type of lab and email to
Barbara Snyder snyderb@uncw.edu and Robin Cunningham cunninghamr@uncw.edu
A confirmation email will be sent to you to confirm your request.
All requests must be received 7 days prior to needed date. Failure to submit this form according to policy
may result in inability to obtain equipment.
Name:
Today’s Date:
Contact Email:
Contact Phone Number:
Organization:
Pick-up Date:
Return Date:
Intended Use of Equipment:
Time:
Time:
By Whom:
By Whom:
Health Fair
Teaching Project
OTHER (Please Specify):
List Request for Equipment/Teaching Materials (See page 2-4 for available items – include quantity):
List Request for other equipment not listed (include quantity):
********************************************************************
Request: Approved:
Denied (Reason):
Pickup Location:
McNeill Hall 2006 Simulation Storage
1
Date Sent:
HEALTH ASSESSMENT EQUIPMENT
Blood Pressure Cuff: Adult (Regular / Large / Thigh), Child, Infant
Breast Model: Single / Triple / Full Breast Torso Model / Male Breast
Community Health Glucometer Bag
Neuro Testing Kit
Opthalmoscope
Otoscope
Pelvic Model
Scale (Floor)
Stethoscope
Testicular Model: Single / Male Pelvic Model
BOOKS (School Age)
TITLE
PUBLISHER
A Guide to Understanding Type 2 Diabetes
Arthur’s Chickenpox
Arthur’s Eyes
Clifford Visits the Hospital w/cassette
Glasses – Who Needs Em
Guide to Common Skin Disorders
I Know How We Fight Germs
I Know Why I Brush My Teeth
Pooh Plays Doctor
The Berenstein Bears Visit the Dentist
The Germ Patrol – All About Shots
The Story of Jeryl Lynn (vaccinations)
How Our Body Works (Large Book)
DISPLAYS
* (FOLDING)
TITLE
Merck
Little Brown & Co.
Little Brown & Co.
Scholastic
Puffin Books
Roche Laboratories
Scholastic
Scholastic
Scholastic
Random House
Scottish Rite Children’s Medical Center
Merck
Henderson Publishing
COPYRIGHT
DATE
2007
1994
1979
2000
1991
1997
1998
1999
1997
1981
1998
1997
1997
+ (3D)
Consequences of High Blood Pressure +
Successful Breastfeeding *
What You Should Know About Nutrition *
With Child *
Preventing Cardiovascular Disease *
Understanding Diabetes *
MANUFACTURER
Health Edco
Childbirth Graphics
Childbirth Graphics
Childbirth Graphics
Health Edco
Health Edco
2
COPYRIGHT
DATE
-2002
2011
2007
2008
2012
GAMES
TITLE
Investigators- A Cooperative Detective Game
Magical Maze-Game of Twists and Turns
The Charades Game-Kids on Stage
Think on Your Feet
Portion and Calorie Bingo Game
MAKER
Family Pastimes
Universal Games
Universal Games
Childs Work Childs Play
Health Edco
AGE
GROUP
6 yrs./ older
3-8 yrs.
6-12 yrs.
8 yrs./older
MODELS
TITLE
1st, 2nd and 3rd Degree Arm Burns
Arthritis
Asthma
Atherosclerosis/Thrombus
Death Of An Artery
Fat 1 Lb. and 5 Lb.
Heart
Large Dental Care Model with Toothbrush
Liver Model with Pathologies
Muscle 1 Lb. and 5 Lb.
TB Testing Arm
Varicose Vein Leg W/Stasis Ulcer
POSTERS
*(HARD LAMINATE)
TITLE
Arthritis- Joint Inflammation +
Determining Body Mass +
Heart Disease +
Hypertension *
Maintaining A Healthy Weight +
The Muscular System *
The Respiratory System *
The Skeletal System *
Understanding Breast Cancer +
Understanding Diabetes * +
Understanding Hypertension +
Understanding Osteoporosis *
Understanding Stroke * +
Diabetes Portion Plate +
VENDOR
Laerdal
Celebrex
Flovent
ALTAX Scientific
Health Edco
Life Form
GPI Anatomicals
Health Edco
GPI Anatomicals
Life Form
Health Edco
Laerdal
+(SOFT PLASTIC)
VENDOR
Anatomical Chart Co
Health Edco
Anatomical Chart Co
Anatomical Chart Co.
Anatomical Chart Co
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
Anatomical Chart Co.
beBetter Networks, Inc
3
COPYRIGHT
YEAR
1999
2001
2008
2000
2001
2000
1990
2000
2006
1992,2004
1999
1993
1992, 2006
2009
Female Stroke Warning Signs (2)
Male Stroke Warning Signs (2)
Female Stroke Warning Signs –Spanish (2)
Genentech USA, Inc
Genentech USA, Inc
Genentech USA, Inc
2010
2013
2013
COMMUNITY HEALTH POSTERS
TITLE
Sugary Stats
HTN – Hypertension
Breast Cancer
Cholesterol
MRSA
Fall – Balance
Safe Medication
Physical Activity
STDs
HIV
Healthy Teens
Asthma
Improve Your Health With Exercise
TEACHING ACTIVITY KITS
TITLE
A is for Asthma
Be Sun Smart
Blubber Busters - Calories You
Can Feel
Breast Milk Composition
Dirty Details: Breastfed Baby
Stool Poster w/diaper samples
Getting to Know Your Heart School Site Program
Glow Germ with Blacklight
Heart Power
How Much Fat? (Tubes)
How Much Salt? (Tubes)
How Much Sugar? (Tubes)
Safe Body Kit (abuse)
The Portion Plate: Adult™
VENDOR
AGE GROUP
YEAR
Health Child Care-NC
Health Child Care-NC
Health Edco
School age
School age
School age
1998
1989
Childbirth Graphics
Childbirth Graphics
-
2011
American Heart Assoc.
Upper elementary
1990
American Heart Assoc.
Young Peoples Healthy
Heart Program
Young Peoples Healthy
Heart Program
Young Peoples Healthy
Heart Program
Health Edco
beBetter Health, Inc.
K-2
-
1996
_
-
_
-
_
School age
-
-
4
The Portion Plate: Child™
Yummy Fruit and Vegetable
Activity Pack
beBetter Health, Inc.
Yummy Designs
School age
VIDEO/CD (School Age)
TITLE
PUBLISHER
The Reason for Sneezing
Sickle Cell Slime-O-Rama Game w/CD
XYLO – Managing Diabetes Game w/CD
Hector, Maria & AC Meet the Germs CD
Fitting CF into Your Life Every Day
ACAAI
Starbright Foundation
Starbright Foundation
Balducci Productions
Starbright Foundation
5
1995
COPYRIGHT
YEAR
1997
2001
1998
1995
2001