Break Room & Grocery List Order Form
Questions? Please email: janeti@health.solutions
Please submit your orders by Friday @ 12:00pm. Orders will be placed every Tuesday - Friday.
Requester
*
First Name
Last Name
Email
*
example@example.com
Department/Program
*
Deliver To
*
Building/Location
Beverages
Soda orders are for board rooms only.
Pepsi
Diet Pepsi
Coke
Diet Coke
Dr. Pepper
Diet Dr. Pepper
Sprite
Diet Lipton Green Tea with Citrus
Sweet Tea
Peach Tea
Bubblè
LaCroix
Other Suggestions
Coffee Items
Regular Coffee
Decaf Coffee
Coffee Mate Hazelnut
Coffee Mate French Vanilla
Coffee Mate Original
MooMoo (Half and Half)
Delight French Vanilla (Special Order)
Sugar Packets
Delight Hazelnut Individual Creamers (Special Order)
Sugar Packets (Special Order)
Creamer Packets
Sweet-N-Low (Special Order)
Coffee Stir Sticks
Coffee Filters
Other Suggestions
Tea Items
Lipton Black Tea (312 Quantity)
Bigelow Green Tea (176 Quantity)
Numi Tea (Email for List)
Conference Room Snacks
Keebler Cookies & Crackers Variety (Special Order)
Frito Mix Chips & Snacks
Cheez-Its
Planters Peanuts (Special Order)
Gold Fish
Nutri-Grain Bars Variety
Kellog's Fruity Snacks
KIND Minis (Staff Break Room Only)
Gardettos
Sun Chips
Baked Potato Chips
Mini Pretzels
Chex Mix (Online takes more time to come in)
Mini Belvita
Other Suggestions
Cups-Plates-Utensils
Coffee Cups 12oz (176 Quantity)
Coffee Lids 12oz (500 Quantity)
Biodegradable Cold Beverage Cups 9oz (For Drinking Fountains & Water Dispensers)
Paper Plates: Large 8.5" (300qty)
Paper plates: Small 6" (300qty)
Bowls 20oz (200qty)
Forks (600qty)
Spoons (600qty)
Knives (600qty)
Paper Towels
Napkins
Cleaning & Disinfectants
Lysol Spray
Clorox Wipes
Dish Soap
Fabreeze
Additional Items
Groceries for IOP, Learning Tree, Recovery and Respite
Copy/Paste Your List
Submit
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