Order Supplies Form

Please place your orders at least 2 days before the next scheduled paycheck delivery.

If there are any issues with your order, please contact Tim by email to support@newoaklandpharmacy.com or by phone at Extension 504.

For “Miscellaneous” items, please provide a short description.

Thank you!

Items may be substituted depending on availability.

Email (to send receipt):*
Today's Date:*


Face Masks (#50/box):
Gloves - specific size S, M, or L (box):
Hand Sanitizer Refill (automatic dispenser) (each):
Hand Sanitizer (for countertop) (each):


Ballpoint Pens - BLACK (#12/pkg)
Ballpoint Pens - BLUE (#12/pkg):
Batteries - AA (each):
Batteries - AAA (each):
Binder Clips - Small, Medium, Large (box):
Box cutter (each):
Box cutter blades (pkg):
Calculator (each):
Cash Register Point-of-Sale (POS) Paper (each):
Compressed Air (each):
Dry Erase Markers - BLACK, RED, or BLUE (each):
Highlighters (each):
Ink Refill (BLUE) for self-inking stamps (each):
Ink Refill (RED) for self-inking stamps (each):
Ink Refill (BLACK) for self-inking stamps (each):
Paper Clips - Standard (box):
Paper Clips - Large (box):
Paper for Printer (case):
Paper - Sticky Pads/Post-Its (1x1) or (3x3) (each):
Permanent Markers (Fine point-BLACK) (box of 12):
Permanent Markers (FINE point-BLUE) (box of 12):
Permanent Markers (FINE point-RED) (box of12):
Rubberbands - thin size #19 (1lb bag):
Rubberbands - regular size #33 (1lb bag):
Rubberbands - large size #117 (1lb bag):
Scissors (each):
Scotch Tape (each):
Sharpies (ULTRAfine point-BLACK) (box of 12):
Sharpies (ULTRAfine point-BLUE) (box of 12):
Sharpies (ULTRAfine point-RED) (box of 12):
Staples, 1/4" regular size #35108 (#5000/box):
Staples, CROWN B8 (#5000/box):
Staples, HC #35550 - high capacity (#2500/box):
Tape 1" (each):
Tape 2" (each):
Telephone Cord (each):
Toner (submit model # of toner or machine):
Whiteout/Correction tape (each):


Baskets for Filling Prescriptions (each):
Paper Bags #2 (#500/pk):
Paper Bags #4 (#500/pk):
Paper Bags #6 (#500/pk):
Paper Bags #8 (#500/pk):
Paper Bags #20 (#500/pk):
Paper Bags #12 (#500/pk):
Prescription Labels (325 labels/roll; 18 rolls/case)(case):
Paper Bags #65 (#500/pk):
Sandwich Bags - Resealable (box):
Zipper Plastic Bags - Quart (box):
Zipper Plastic Bags - Gallon (box):
Reusable Fabric Bags - HM (case):


Disinfectant Surface Spray (each):
Garbage Bags - small 13 gallon (box):
Garbage Bags - large 33 gallon (box):
Dishwashing Soap (each):
Handsoap Refill (each):
Paper Towels (case):
Sponges (each):
Swiffer 360 Duster Refills (box):
Swiffer DRY Sheet Refills (box):
Swiffer WET Sheet Refills (box):
Tissue/Kleenex (box):
Toilet Paper (pkg):

$$$ CHANGE $$$

$1 Bill(s):
$5 Bill(s):
$10 Bill(s):
Pennies (1 cent) - 50 cent rolls:
Nickels (5 cents) - $2 rolls:
Dimes (10 cents) - $5 rolls:
Quarters (25 cents) - $10 rolls:


COLD ICE (case):
Liners for Cold Packages (small or large-by case):
Bubble Bags (#150/case):
Padded Envelopes #0 - small (#150/case) :
Padded Envelopes #2 - large (#100/case):
Stamps (indicate denominations and amounts):


Blood Pressure Monitors (REG cuff):
Blood Pressure Monitors (SML cuff):
Brita Filter Replacements (each):
Condoms (12/box) (box):
COVID-19 tests (2 tests/kit) (kit):
PUR Filter Replacements (each):
Light Bulbs (please explain):
Other (short description):

Please complete YOUR NAME then click SUBMIT.

Your order will be sent to Tim by email and a copy will be sent to you.

Your Name:*