Needs Assessment Medical Lab Medical Lab Name

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Needs Assessment Medical Lab Medical Lab Name _________________________________________________ Location _________________________________________________ Department _________________________________________________ Individual Interviewed _________________________________________________ Phone ________________________________ Date ____________________________ Current PPE Lab Coats Used Brand _______________________________________________ Style No _____________________________________________ Fabric Composition % Poly % Cotton Front ______ ________ Back ______ ________ Date Coats Originally Installed ? __________________ Current Provider of PPE Lab Coats ________________________________________________________ Contract Length_________Months Remaining on Contract ____________ Considering Only the Lab Coats, What would you Like Improved in the Next Coats you Rent? Fluid Resistance _______________________________________________________ 360 Protection _______________________________________________________ Coats Sanitized ______________________________________________________ Tapered Sleeves with Fitted Cuffs _____________________________________________ Sizes for All Employees O- XS ___________________________________________ O- 4XL and 5XL ___________________________________ Color Options _______________________________________________________ Length Options Needed O- 41” O- 34” O- 31.5” Air Permeability/Comfort ___________________________________________________ Anti-Static Fabric ___________________________________________________ Lint Free for Molecular ___________________________________________________ Stain Resistance ____________________________________________________ What causes most Stains? __________________________________________ _____________________________________________ Pockets Construction _____________________________________________________ Cuffs _____________________________________________________ Snap Durability _____________________________________________________ Other Needing Improvement ___________________________________________________ Circle above the 3 most important Attributes you would like improved with New Coats File: DenLine-Research 9-25-17