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Only approved WIC agencies that contract with the Washington State Department of Health may use this order form to order clinic Hematology orders. The Washington State WIC Program only pays for items listed on this order form. We place orders every Friday if received by COB on Thursday. Orders usually arrive 11-14 days after we place them. Send a copy of the packing slip or confirmation within 3 days of receiving your order to WICHematology@doh.wa.gov Fax # 360-236-2320 Information collected via this form may be subject to release in accordance with RCW 42.56 (Public Records Act). |
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1. | Clinic Information (Required) | | |
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• Please beware - Some items may have an Expiration Date.
• Please order accordingly to your clinic caseload, clinic need and for a limited timeframe. |
2. | McKesson Hematology Supplies: (Send packing slip to State WIC office within 3 days) | | |
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3. | Masimo Hematology Supplies: (Send packing slip to State WIC office within 3 days) | | |
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4. | HemoCue Hematology Supplies: (Send packing slip to State WIC office within 3 days) *Only order the 301 Microcuvettes for the 301 Analyzers | | |
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