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Hand Protection Analysis

Please complete the requested information below to ensure our recommendation of hand protection is the perfect fit for your application.

Company Name:
Contact Name:
E-mail Address:
Mailing Address:
City:
State:
Zip Code:
Country/Region:
Phone Number:
Best Time To Contact:
Describe the application being performed.
Is there exposure to blades? Yes No
Is there exposure to cable? Yes No
Is there exposure to glass? Yes No
Is there exposure to metal? Yes No
Is there exposure to wood? Yes No
Is there abrasion? Yes No
Are there cut concerns? Yes No
Describe abrasion or cut concerns.
Is there exposure to chemicals? Yes No
If so, what chemical?
If more than one chemical is used, provide percentage and mixture.
If working with chemicals, are hands immersed or only subjected to splash conditions? :
If exposed to heat and/or cold application, confirm the following.
Tempature:

Exposure Time:

Weight Of Object(s) Handled:
Are there other risks/hazards for your application? Yes No
If yes, explain other risks/hazards.
Describe the style of hand protection that is currently being used.
(provide manufacturer's item number if possible)
Does the current glove provide the appropriate protection? Yes No
If no, what needs to be changed or improved with the current glove being used.
Describe the appearance of the gloves you are currently using after exposure to the application.
(identify the critical wear areas)
How long do the current gloves last?
(in hours, days or weeks)
What is the monthly consumption in pairs?
(in hours, days or weeks)
What are your current costs per pairs?
(in hours, days or weeks)
Identify the number and type of hand injuries during the past 12 months.
Are you laundering your gloves? Yes No
If yes, how many times can they be washed before replacing?
What is the procedure for new gloves to be issued?
What is the disposition of the gloves being replaced?
Who are your current glove suppliers?
Additional information or comments:
RED FIELDS ARE REQUIRED
  


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MCR Safety • 5321 East Shelby Drive • Memphis, TN 38118
Phone: 800-955-6887 • Fax: 800-821-6543