Staff Uniform Order Form Order ReferenceUse this form to order your staff uniform. An order will be placed with the supplier when we receive this form. All uniforms should be ordered well before they are needed. Your uniform is delivered directly to your department or ward. This form is only for uniforms usually ordered through the Linen Service. If you require extra uniforms or items that are not budgeted for, such as a hoodie, you will need to pay at the General Office beforehand and then send the receipt to the Linen Room, CHH before the item(s) can be ordered. Unfortunately we are unable to offer a trying on service at the moment, due to Covid-19. You can order one uniform per shift per week, up to a maximum of 5 uniforms. Please refer to the Uniform Sizing Guide before ordering. Please remember you must ask permission from your budget holder before ordering.Is this uniform for you or someone else?(Required) Myself Someone else Why are you ordering a uniform?(Required) New Starter Replacement New Role Maternity This uniform is for...(Required) Forename Surname Job Title(Required) Ward / Department(Required)AAA ScreeningAcademic Medicine (CHH)Academic OncologyAcute Medicine Med StaffAcute Medicine Specialist NursesAcute Providers CollaborativeAcute RehabAcute Surgery Medical StaffAdmin BankAdmissions/LegalAmbulatory Care Unit (ACU)Ambulatory Care/Day ServicesAMU Nursing HRIAMU/Emergency Dept Admin StaffAnaesthetic Medical StaffAnaesthetic PractitionersAnaesthetics - CardioAnaesthetics - ICUAnaesthetics - ObstetricsAnaesthetics - PainAnaesthetics A&C StaffARAS Airways TeamArchivingAseptic UnitAudiology Department HRIBank Nurses Ex RHHBereavement ServicesBlood and Blood ProductsBlood SciencesBlood Sciences Medical StaffBoots OutpatientsBowel ScreeningBrain & CNS Therapy TeamBreast Clinics CHHBreast Screening UnitBreast Surgery - Specialist NursesBreast Surgery Medical StaffBreast Symptomatic ServicesBrocklehurst/Bilton NHS ClinicsCancer AllianceCancer and Diagnostic Services ManagementCancer Assessment UnitCancer Psychological ServiceCAPD RenalCapital & PlanningCapital SchemesCar Parking and SecurityCardiac 5 Day WardCardiac Cath Lab - CHHCardiac Surgery Medical StaffCardiology and Cardiothoracic Surgery Centre CHHCardiology Med Staff/SpecialtyCardiology Specialist NursesCardiothoracic Audit Dept CHHCare Records ServiceCatering Services CHHCatering Services HRICath LabCE AdminCellPath Medical StaffCellular Pathology (HRI)Central Decontamination UnitCentral Pathology ServicesCentral TherapiesCentralised Ward ClerksCentre for Metabolic Bone DiseaseCFS Capital ProjectsChest Med Med Staff/SpecialtyChest Med Outpatients HRIChest Medicine Specialist NursesChief ExecutiveClaimsClin Haem Med Staff/SpecialtyClinical Audit & EffectivenessClinical CodingClinical EngineeringClinical Engineering CommunityClinical GovernanceClinical ImmunologyClinical Nurse EducatorsClinical Oncology Med StaffClinical Skills BuildingCMU / Ward 28 Cardiology CHHColorectal Medical StaffColorectal Surgery - Specialist NursesComms and Web ServicesCommunity MidwiferyCommunity PaediatricsComplianceCOPD/PARCCosting and IncomeCOVID19 CentralCOVID19 COOCritical Care Clinical Nurse EducatorsCritical Care Outreach ServiceCT Department - HRICT Surgery Theatres CHHCystic Fibrosis ServiceDay Case Surgery Unit CHHDay Case Surgery Unit HRIDay Surgery 3 CHHDay Unit CHCCDerm Med Staff/SpecialityDerm Med Staff/SpecialtyDermatology - Specialist NursesDermatology UnitDieteticsDigital Exemplar (LDE)District RecordsDME Med StaffDME Nurse ManagementDomestic Services All SitesED Clinical EducatorsED Data QualityEducation and DevelopmentElderly Assessment UnitElectrical Clinical Observation SystemElectrocardiography Card CHHEmergency Dep Med Staff HRIEmergency Dept Nurse PractitionersEmergency Dept Nursing Staff HRIEmergency Dept PaediatricsEmergency PreparednessEmployee Service CentreEndo Med StaffEndo/Diabetes Admin StaffEndoscopy Unit CHHEnergy and Utilities CHHEnhanced Care TeamENT - Specialist NursesENT Medical StaffENT Outpatients CHHENT/Breast Theatres CHHEPAUEPDM SystemERMEC Deanery FundedERMEC Non RechargeableERMEC Resus Training HRIE-RosteringESR_DepartmentEstates Department CHHEstates Department HRIFinance AdminFoundation Community PostsFracture Clinic HRIFT Strategy - FinanceGastro Admin & Clerical StaffGastro Med Staff/SpecialtyGastro Theatre HRIGastroenterology - Specialist NursesGeneral OfficeGP Scheme EmployerGrounds and Gdns (CHH)GS1 System ImplementationGynae Oncology Med Staff/SpecialtyGynae Theatres HRIGynaecology OncologyGynaecology Spec NursesH&ER Public Mortuary HRIH30 Cedar WardH31 Maple & H33 Rowan WardsH34 Acorn WardHaemophilia SpecialtyHead of Corporate Human ResourcesHeads of FinanceHealth & SafetyHeart Failure ServiceHEY Improvement TeamHIV ServiceHome VentilationHonorary StaffHospital At NightHR Advisory ServiceHub 10 - Clinical AdminHub 11 - Clinical AdminHub 1a - Clinical AdminHub 1b - Clinical AdminHub 2 - Clinical AdminHub 3 - Clinical AdminHub 4 - Clinical AdminHub 5 - Clinical AdminHub 6 - Clinical AdminHub 7 - Clinical AdminHub 8 - Clinical AdminHub 9 - Clinical AdminHull Dialysis UnitHUTH ProviderHYMS Medical SchoolI&D ManagementICNARC HRIICU A+C StaffICU CHHICU HRIID Admin StaffID Specialist NursesImmunology/Haemophilia OPDInf Diseases Med Staff/SpecialtyInfection ControlInformation ServicesIntegrated Care System (ICS)Integrated Discharge TeamInterventional Rad Theatre HRIIT Services DepartmentLaund and Linen Serv (All)Libraries ManagementLocum RegistrarLung Health AdminLung Health CheckLWABManagement Emergency CareMax Fax Lab HRIMax Fax Specialist NursesMaxillo Facial OutpatientsMDT CoordinatorsMED HG Covid-19Medical BankMedical Day ServicesMedical DirectorMedical Equipment LibraryMedical ExaminerMedical IllustrationMedical Library HRIMedical Oncology Med StaffMedical Outpatients HRIMedical Physics STP and PTPMedical Records ManagementMedicine Service ManagementMHG Admin Team CHHMHG Admin Team HRIMicrobiology DeptMicrobiology Medical StaffMidwifery EducationMidwifery Led UnitMolecular Imaging Research CentreMRI Department - HRINeonatal Med Staff/SpecialtyNeonatal Specialist NursesNeurology Med Staff/SpecialtyNeurology Spec Nurses HRINeurophysiology Dept HRINeurosurgery - Specialist NursesNeurosurgery A&C StaffNeurosurgery Medical StaffNewborn Hearing ScreeningNHS Bank StaffNuclear Medicine DepartmentNursing ChaplainsNursing ServicesObs/Gynae Med Staff/SpecialtyObstetric Spec NursesOccupational Health HRIOccupational TherapyODN (Critical Care Network)Oncology Med Staff/SpecialtyOncology Specialist NursesOphthalmology - Specialist NursesOphthalmology Medical StaffOphthalmology OutpatientsOphthalmology Pre - AssessmentOphthalmology R&D FundOphthalmology Unit TheatresOphthalmology Ward / Daycase UnitOptometry DepartmentOral Surgery ConsortiumOral Surgery Medical StaffOral Surgery Theatres CHHOrganisational DevelopmentOrthopaedic Medical StaffOrthopaedic Patient Admin & AuditOrthopaedic Surgery - Specialist NursesOrthopaedic Theatres CHHOrthoptics Ophthal Department HRIOrthotic Service HRI/CHHOutpatient Antibiotic ServiceOutpatient Clinics CHHOutpatient Clinics ERCHPaed Surg Med Staff/SpecialtyPaediatric Med Staff/SpecialtyPaediatric Nurse ManagementPain Service - ChronicPalliative Med Specialist NursesPalliative Med Staff/SpecialtyParental EducationPathology Med Staff/SpecPatient Admin (Day Surg HRI/CHH)Patient ExperiencePatient LoungePatient Meal ServicesPAUPerformance ManagementPerfusion Dept CHHPHDUPhlebotomy Dept HRIPhysiology CHHPhysiotherapyPlastic Surgery - Specialist NursesPlastic Surgery Medical StaffPlastic Trauma ClinicsPortering Services CHHPortering Services Post RoomPre Admission ServiceProgress to Discharge Unit (PDU)Property ServicesProsthetic Service Syke StProviders - Scunthorpe Vac SitePsychology ServicesPulmonary Function Unit CHHPurchase AccountsR&D Academic CardiologyR&D Academic Oncology Trial FundR&D Colorectal SurgeryR&D Commercial StudiesR&D DermatologyR&D Diabetes FundR&D Dr Patel RheumatologyR&D Gastro IBD Nurse FundR&D Infectious DiseasesR&D Interventional CardiologyR&D Renal Research FundR&D Respiratory GeneralR&D Trauma & Orthopaedics Medical A/CR&D UKCLRN Funding Gastro/HeptoR&D UKCLRN Funding PaediatricsR&D UKCLRN Office CHHR&D Vascular Surgery ResearchR+D Covid-19 Siren StudyRadiation Physics DepartmentRadiation ProtectionRadiol Gen and Screen CHHRadiol Gen and Screen HRIRadiology Administration CHHRadiology ManagementRadiology Medical StaffRadiology Nursing - CHHRadiology Nursing - HRIRadiology PACsRadiotherapyRadiotherapy PhysicsRapid Diagnostics ProgrammeRecords Libraries CHHRecovery Service Theatres CHHRecovery Service Theatres HRIRegional Training Centre Endoscopy (CHH)RehabilitationRehabilitation EngineeringRenal Admin StaffRenal Med StaffRenal Specialist NursesReporting RadiographerResearch & DevelopmentResearch & Development - AnaestheticsRetinal ScreeningRheum Med StaffRheumatology Specialist NursesRisk ManagementRisk TeamSafeguarding Children HRISite ManagementSpecialist Dieticians - DiabetesSpecialist Nurses - Clinical HaematologySpecialist Nurses - Endo/DiabetesSpecialist Services ManagementSpeech TherapyStatutory ComplianceStoma Care - Specialist NursesStrategy and PlanningStroke ServicesStroke Specialist NursesStructured Education (Endo/Diabetes)StudentsSupplies DepartmentSurgery 1 ManagementSurgical Admissions LoungeSwitchboardSystem Bank StaffSystem Programme Management OfficeTeacher Trainer TeamTeam 1 - NeurosurgeryTeam 2 - VascularTeam 3 - OrthopaedicsTeam 4 - Max FaxTeam 5 Theatre Co-ordinatorTech Development GroupTeenage and Young Adult UnitTelecommunicationsThe Department of PharmacyTheatres Education DepartmentTheatres General (CHH)Theatres General HRIThoracic Surgery Medical StaffTower Block 5th Floor HRITransformation and Change TeamTransport Services Non PatientTrauma CentreUltrasoundUltrasound - HRIUpper GI - Specialist NursesUpper GI Admin & Clerical StaffUpper GI Medical StaffUpper GI TheatresUrology Medical StaffUrology Surgery - Specialist NursesUrology Theatres CHHVascular Lab HRIVascular Surgery - Specialist NursesVascular Surgery Admin & Clerical StaffVascular Surgery Medical StaffWard 1 HRIWard 10 - Colorectal Surgery CHHWard 10 Endo HRIWard 100 (Gastro/Gm HRI)Ward 11 Colo Rectal Surgery CHHWard 11 Stroke Serv HRIWard 110 Stroke Unit HRIWard 12 HRIWard 120 HRIWard 14 Upper GI Surgery CHHWard 15 Urology CHHWard 16 (Breast - CHH)Ward 26 CT Surgery CHHWard 27 CT Surgery CHHWard 29 Rehab CHHWard 30 CHHWard 31 CHHWard 32 CHHWard 33 CHHWard 37 Chest MedicineWard 38 DME (Elderly)Ward 4 Neuro HRIWard 40 Neuro HOBWard 5 Chest Med HRIWard 50 Renal HRIWard 500 Chest Medicine HRIWard 6 Acute Admissions HRIWard 60 Acute Admissions HRIWard 7 CHHWard 7 Vascular Surgery HRIWard 70 Endo HRIWard 70 Rheumatology HRIWard 8 Eld MedWard 9 Eld Med HRIWard 9 Elderly MedicalWard 9 Ortho/Breast CHHWard 90 Eld Med HRIWard Catering ServiceWard H130 PaediatricsWaste ManagementWCH Gynaecology OP (HRI)Wch Labour and Delivery (HRI)Winter Ward HRIWomens and Childrens ANC/ADU HRIWomens and Childrens NICU HRIWomens and Childrens Paediatric OP HRIWomens/Childrens Serv MgtWorkforce PlanningYour name (NOT the person the uniform is for)(Required) First Last Your Email Address(Required) Cost Code(Required) Transfer Point(Required)This is a 6-digit alphanumeric code. It is not the name of your department. Your charge nurse, ward clerk or ward housekeeper will know what it is. Please deliver the uniform to...(Required)Hull Royal InfirmaryCastle Hill HospitalWomen and Children's HospitalQueen's CentreBrocklehurst BuildingEast Riding Community HospitalEye HospitalOtherWhere?(Required) So we can show you the correct products and sizes, please choose which range of uniform you'd like to order from:(Required) Womenswear Menswear Maternity Wear Which uniform items do you need to order?(Required) Dress Tunic Trousers Polo Shirt Other Which uniform items do you need to order?(Required) Tunic Trousers Polo Shirt Other Number of Dresses(Required)12345Number of Tunics(Required)12345Tunic/Dress Main Colour(Required)Hospital Blue (Staff Nurse, Specialist Nurse or Nurse Associate)Navy BlueRoyal BluePale BlueWhiteBlue and White StripeBurgundyAquaConvoy GreyOtherHospital Blue Tunic/Dress Trim Colour(Required)White - Staff NurseNavy Blue - Specialist NurseYellow - Nurse AssociateAqua Tunic/Dress Trim Colour(Required)White - Ward HygienistConvoy Grey Tunic/Dress Trim Colour(Required)WhiteRoyal Blue Tunic/Dress Trim Colour(Required)White - MidwifeNavy Blue - Specialist MidwifePale Blue Tunic/Dress Trim Colour(Required)White - Physiotherapy AssistantNavy - Clinical Imaging Support WorkerBlue and White Stripe Tunic/Dress Trim Colour(Required)Navy Blue - Clinical Support WorkerWhite - Health Care AssistantNavy Blue Tunic/Dress Trim Colour(Required)White - Charge Nurse / SisterRed - MatronWhite Tunic/Dress Trim Colour(Required)Navy Blue - PhysiotherapistPeacock - DieticianBottle Green - Occupational TherapistBurgundy - PhlebotomistWhite - Nurse Associate TraineeBurgundy Tunic/Dress Trim Colour(Required)Cream - Ward HousekeeperOther Tunic/Dress Main Colour(Required) Other Tunic/Dress Trim Colour(Required) Dress Size(Required)76cms80cms84cms88cms92cms96cms100cms104cms108cms112cms116cms120cms124cms128cms132cms136cms140cms144cms148cmsDress Length(Required)Short - 100cmsRegular - 106cmsTall - 112cmsUnhemmed - 122.5cmsWomen's Tunic Size(Required)8084889296100104108112116120124128132136140144148Maternity Dress Size(Required)All maternity dresses come unhemmed.68101214161820222426Men's Tunic Size(Required)84889296100104108112116120124128132136140Maternity Tunic Size(Required)68101214161820222426Number of Trousers(Required)12345Trouser Colour(Required)Navy BlueBlackBottle GreenBurgundyOtherOther Trouser Colour(Required) Women's Trouser Size(Required)681012141618202224262830323436Women's Trouser Length(Required)Short - 27 inchRegular - 29 inchTall - 31 inchUnhemmedMen's Trouser Size(Required)2830323436384042444648505254Men's Trouser Length(Required)Short - 29 inchRegular - 31 inchTall - 33 inchUnhemmedMaternity Trouser Size(Required)68101214161820222426Maternity Trouser Length(Required)Short - 27 inchRegular - 29 inchTall - 31 inchUnhemmedNumber of Polo Shirts(Required)12345Polo Shirt Colour(Required)NavyWhiteRoyal BlueBlackRedBurgundyPurplePeacockPale BlueLilacGrey/CharcoalJadeOtherPolo Shirt Size(Required)XSSMLXL2XL3XL4XLOther Polo Shirt Colour(Required) Which other item(s) do you want to order?(Required)You specified above that you'd like to order items that aren't listed on the standard form. Please give as much detail as possible, including style/fit, size, colour, etc.Is any embroidery required?If any embroidery is required on any garment, please specify the text required, the position on the garment, and what colour the text should be. Please also indicate if the NHS or trust logo is required. We cannot return embroidered garments if a mistake is made, so this could mean your ward or department is charged.Are you ordering a uniform that requires you to send us a payment receipt?(Required)If so, please make payment at the General Office and send the receipt to the Linen Room, CHH. Your garment(s) cannot be ordered until we receive the receipt. Yes No Anything else we should know?Use this box to tell us anything else we might need to know before we process your order.By completing and submitting this form, I confirm that I have permission from my uniform budget holder to place this order.(Required) I agree Sizing Guide Women's Tunic Dress Men's Tunic Old Sizing New Sizing Old Sizing New Sizing Old Sizing New Sizing UK size Cms UK size Cms Inches Cms 6 80 6 76 8 84 8 80 10 88 10 84 32 84 12 92 12 88 34 88 14 96 14 92 36 92 16 100 16 96 38 96 18 104/108 18 100 40 104 20 112 20 104/108 42 108 22 116 22 112 44 112 24 120 24 116 46 116 26 124/128 26 120 48 124 28 132 28 124/128 50 132 30 136 30 132 52 136 32 140 32 136 54 140 34 144 34 140 36 148 36 144/148 Tunics and dresses are now ordered in centimetres. Dresses – Short 100cm – Regular 106cm – Tall 112cm – Unhemmed 122.5cm Women's trousers are still in UK sizes (i.e. 10, 12, 14 etc.) lengths are – Short 27ins – Regular 29ins – Tall 31ins – XTall 33ins Men's trousers are still in inches (i.e. 38, 40, 42 etc.) lengths are - Short 29ins – Regular 31ins – Tall 33ins – XTall 36ins Tunics come in one length only.