EXHIBIT 10.30

                                  CONFIDENTIAL
             Surgical Safety Products, Inc., a New York corporation

                  INVESTOR SUITABILITY EVALUATION QUESTIONNAIRE

1.    NAME        ___________________________________________________

2.    ADDRESS     ___________________________________________________

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3.    PHONE       Residence         (     )_____________________________
                  Business          (     )_____________________________

4.    SOCIAL SECURITY NUMBER              ___________________________

      TAX IDENTIFICATION NUMBER           ___________________________

5.    DATE OF BIRTH     _____________________________________________

6.   REPRESENTATIONS (Investor should initial the appropriate blanks to which an
     affirmative representation can be made)

                    _______________  The total  purchase  price  does not exceed
                    twenty percent (20%) of my net worth at the time of the sale
                    and my  subscription  is at least One Hundred Fifty Thousand
                    Dollars ($150,000.00).

                    _______________  I have a net worth of One  Million  Dollars
                    ($1,000,000.00) or more.

                    _______________  I have an  income of Tow  Hundred  Thousand
                    Dollars  ($200,000.00)  or more in each of the  past two (2)
                    years and during the current year.

                    _______________  The total  purchase  price  does not exceed
                    twenty percent (20%) of my net worth.

     I further  represent  that I can bear the economic risk of this  investment
and that I have substantial  experience in making  investment  decisions of this
type.

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              Name of Investor                          Signature of Investor

                          Date:___________________________




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                       INVESTOR SUITABILITY STANDARDS AND
                             INVESTMENT RESTRICTIONS


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Suitability

     Shares will be offered and sold pursuant an exemption  under the Securities
Act, and exemptions  under  applicable state securities and Blue Sky laws. There
are different  standards under these federal and state  exemptions which must be
met by prospective investors in the Company.

     The Company will sell Shares only to those Investors it reasonably believes
meet certain suitability requirements described below.

     Each   prospective   Investor  must  complete  a   Confidential   Purchaser
questionnaire  and  each  Purchaser  Representative,  if any,  must  complete  a
Purchaser Representative Questionnaire.

     EACH INVESTOR MUST BE RESPONSIBLE FOR  DETERMINING  THAT IT IS PERMITTED TO
INVEST  IN THE  COMPANY,  THAT ALL  APPROPRIATE  ACTIONS  TO  AUTHORIZE  SUCH AN
INVESTMENT HAVE BEEN TAKEN,  AND THAT ANY  REQUIREMENTS  THAT ITS INVESTMENTS BE
DIVERSIFIED OR SUFFICIENTLY LIQUID HAVE BEEN MET.

     An investor will qualify as an  accredited  Investor if it falls within any
one of the  following  categories  at the time of the sale of the Shares to that
Investor:

          (1) A bank as defined in Section  3(a)(2) of the Securities  Act, or a
     savings and loan  association  or other  institution  as defined in Section
     3(a)(5)(A)  of the  Securities  Act,  whether  acting in its  individual or
     fiduciary capacity; a broker or dealer registered pursuant to Section 15 of
     the  Securities  Exchange Act of 1934;  an insurance  company as defined in
     Section 2(13) of the Securities Act; an investment company registered under
     the  Investment  Company Act of 1940 or a business  development  company as
     defined  in  Section  2(a)(48)  of that Act;  a Small  Business  Investment
     Company licensed by the United States Small Business  Administration  under
     Section 301(c) or (d) of the Small Business  Investment Act of 1958; a plan
     established and maintained by a state, its political  subdivisions,  or any
     agency or instrumentality of a state or its political subdivisions, for the
     benefit  of its  employees,  if such  plan has  total  assets  in excess of
     $5,000,000;  an employee  benefit  plan within the meaning of the  Employee
     Retirement Income Security Act of 1974, if the investment  decision is made
     by a plan  fiduciary,  as defined in  Section  3(21) of that Act,  which is
     either  a  bank,  savings  and  loan  association,  insurance  company,  or
     registered  investment  adviser,  or if the employee benefit plan has total
     assets in  excess  of  $5,000,000,  or,  if a  self-directed  plan with the
     investment decisions made solely by persons that are accredited  investors;
     (2) A private business development company as defined in Section 202(a)(22)
     of the Investment Advisers Act of 1940;

          (3) An  organization  described  in Section  501(c)(3) of the Internal
     Revenue Code with total assets in excess of $5,000,000;

          (4) A director or executive officer of the Company.

          (5) A natural person whose  individual  net worth,  or joint net worth
     with that person's  spouse,  at the time of such  person's  purchase of the
     Shares exceeds $1,000,000;

          (6) A  natural  person  who had an  individual  income  in  excess  of
     $200,000  in each of the two most  recent  years or joint  income with that
     person's  spouse  in excess of  $300,000  in each of those  years and has a
     reasonable  expectation  of reaching  the same income  level in the current
     year;


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          (7) A trust with total assets in excess of $5,000,000,  not formed for
     the specific purpose of acquiring the securities offered, whose purchase is
     directed by a  sophisticated  person as describe in Rule  506(b)(2)(ii)  of
     Regulation D; and

          (8) An  entity  in  which  all of the  equity  owners  are  accredited
     investors (as defined above).

     As used in this Memorandum,  the term "net worth" means the excess of total
assets over total  liabilities.  In  computing  net worth for the purpose of (5)
above, the principal residence of the investor must be valued at cost, including
cost of improvements,  or at recently appraised value by an institutional lender
making a secured loan, net of  encumbrances.  In determining  income an investor
should add to the investor's  adjusted gross income any amounts  attributable to
tax exempt income  received,  losses claimed as a limited partner in any limited
partnership,  deductions claimed for depletion, contributions to an IRA or KEOGH
retirement plan, alimony payments, and any amount by which income form long-term
capital gains has been reduced in arriving at adjusted gross income.

     In  order to meet  the  conditions  for  exemption  from  the  registration
requirements under the securities laws of certain  jurisdictions,  investors who
are  residents  of  such   jurisdiction  may  be  required  to  meet  additional
suitability requirements.

     An  Investor  that  does  not  qualify  as  an  accredited  Investor  is  a
non-accredited Investor and may acquire Shares only if:

          (1) The  Investor is  knowledgeable  and  experienced  with respect to
     investments  in limited  partnerships  either  alone or with its  Purchaser
     Representative, if any; and

          (2) The Investor has been provided access to all relevant documents it
     desires or needs; and

          (3) The  Investor  is  aware of its  limited  ability  to sell  and/or
     transfer its Shares in the Company; and

          (4) The  Investor can bear the economic  risk  (including  loss of the
     entire  investment)  without  impairing  its  ability  to  provide  for its
     financial  needs and  contingencies  in the same  manner as it was prior to
     making such investment.

     THE COMPANY RESERVES THE RIGHT IN ITS ABSOLUTE DISCRETION TO DETERMINE IF A
POTENTIAL INVESTOR MEETS OR FAILS TO MEET THE SUITABILITY STANDARDS SET FORTH IN
THIS SECTION.

Additional Suitability Requirements for Benefit Plan Investors

     In addition to the foregoing  suitability standards generally applicable to
all Investors,  the Employee  Retirement Income Security Act of 1934, as amended
("ERISA"), and the regulations promulgated thereunder by the Department of Labor
impose certain additional suitability standards for Investors that are qualified
pension,  profit-sharing  or stock bonus plans  ("Benefit  Plan  Investor").  In
considering  the purchase of Shares,  a fiduciary  with respect to a prospective
Benefit Plan  Investor  must  consider  whether an investment in the Shares will
satisfy the prudence  requirement of Section  404(a)(1)(B) of ERISA, since there
is not expected to be any market  created in which to sell or otherwise  dispose
of the Shares.  In addition,  the fiduciary must consider whether the investment
in Shares will satisfy the diversification  requirement of Section  404(a)(1)(C)
of ERISA.

Restrictions on Transfer or Resale of Shares

     The  Availability  of Federal and state  exemptions and the legality of the
offers and sales of the Shares are  conditioned  upon,  among other things,  the
fact that the purchase of Shares by all  Investors are for  investment  purposes
only  and  not  with  a  view  to  resale  or  distribution.  Accordingly,  each
prospective Investor will be required to represent in the Subscription Agreement
that it is  purchasing  the Shares for its own  account  and for the  purpose of
investment  only, not with a view to, or in accordance with, the distribution of
sale of the  Shares and that it will not sell,  pledge,  assign or  transfer  or
offer to sell, pledge, assign or transfer any of its Shares without an effective
registration  statement  under the  Securities  Act, or an  exemption  therefrom
(including  an  exemption  under  Regulation  D,  Section 504) and an opinion of
counsel acceptable to the Company that  registration  under the  Securities


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Act is not required and that the transaction  complies with all other applicable
Federal and state securities or Blue Sky laws.







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                         Surgical Safety Products, Inc.
                            (A New York corporation)

                               ==================

                             SUBSCRIPTION DATA SHEET

                               ==================
Name of Subscriber
(Offeree):________________________________________________________________

Address of Residence
(if natural person):_______________________________________________________

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Address of
Business:_________________________________________________________________

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Subscriber's
Telephone No.:____________________________________________________________

Subscriber's Social
Security No. or
Tax I.D. No.:______________________________________________________________

Preferred Address for
             receiving ma( ) Residenc( ) Business( ) Other, if any:

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Date of Subscription:_______________________________________________________

Amount of Subscrip$______________________________





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                      SUBSCRIPTION AGREEMENT AND INVESTMENT
                           REPRESENTATION OF INVESTORS

Surgical Safety Products, Inc.
SSP Corporate Center
2018 Oak Terrace
Sarasota, FL 34231

Gentlemen:

1.   Subject to the terms and conditions hereof,  the undersigned,  intending to
     be legally bound,  hereby  irrevocably  subscribes for and agrees to accept
     and subscribe to (a)_________ shares of Rule 144 Restricted common stock of
     Surgical Safety Products,  Inc., a New York corporation (the Company), and,
     (b) ___________________  five (5) year Warrants to purchase a share of Rule
     144  Restricted  Common Stock of the Company at an exercise  price of $1.00
     per share, for a total  consideration of  $______________,  the receipt and
     sufficiency of which is hereby acknowledged.

2.   In order to induce the Company to accept the subscription made hereby,  the
     undersigned  hereby represents and warrants to the Company,  and each other
     person who acquires or has acquired the Shares, as follows :

          (a) The  undersigned,  if an  individual  (i) has  reached  the age of
     majority in the state in which he resides and (ii) is a bona fide  resident
     and  domiciliary  (not a temporary or transient  resident) of the state set
     forth beneath his signature below.

          (b) The  undersigned  has the  financial  ability to bear the economic
     risk of an investment in the Shares has adequate means of providing for his
     current needs and personal contingencies, has no need for liquidity in such
     investment,  and  could  afford a  complete  loss of such  investment.  The
     undersigned's  overall  commitment  to  investments  that  are not  readily
     marketable is not  disproportionate to his net worth, and his investment in
     the Company will not cause such overall commitment to become excessive.

          (c) The undersigned meets at least one of the following criteria:

               (i) the  undersigned  is a natural  person whose  individual  net
          worth or joint net worth with his spouse, at the time of his purchase,
          exceeds $1,000,000 (ONE MILLION DOLLARS); or (ii) the undersigned is a
          natural  person  and had an  individual  income in excess of  $200,000
          (TWO-HUNDRED  THOUSAND  DOLLARS) in each of the two most recent years,
          or  jointly  with his  spouse  in excess  of  $300,000  (THREE-HUNDRED
          THOUSAND  DOLLARS) in each of those years, and who reasonably  expects
          to achieve at least the same  income  level in the  current  year;  or
          (iii)  qualifies as an accredited  investor under  Regulation D of the
          Securities Act of 1933 (the "Act").

          (d) The  investment is one in which I am purchasing for myself and not
     for others, the investment amount does not exceed 10% of my net worth and I
     have the capability to understand the investment and the risk.

          (e) The undersigned has been given a full opportunity to ask questions
     of and to  receive  answers  from the  Company  concerning  the  terms  and
     conditions  of the offering and the business of the Company,  and to obtain
     additional  information necessary to verify the accuracy of the information
     given him or to obtain  such  other  information  as is desired in order to
     evaluate an investment in the Shares. All such questions have been answered
     to the full satisfaction of the undersigned.

          (f) In making his  decision to purchase the Shares  herein  subscribed
     for, the undersigned has relied solely upon independent investigations made
     by him. He has received no  representation  or warranty from the Company or
     from a broker-dealer, if any, or any of the affiliates, employees or agents
     of either.  In  addition,  he is not  subscribing  pursuant  hereto for any
     Shares  as a result of or  subsequent  to (i) any  advertisement,  article,
     notice or other  communication  published  in any  newspaper,  magazine  or
     similar media or broadcast over television or radio, or (ii) any seminar or
     meeting whose attendees,  including the undersigned,  had been invited as a
     result of, subsequent to, or pursuant to any of the foregoing.


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          (g)  The  undersigned  understands  that  the  Shares  have  not  been
     registered  under  the  Act  in  reliance  upon  specific  exemptions  from
     registration  thereunder,  and he agrees  that his  Shares may not be sold,
     offered for sale, transferred, pledged, hypothecated, or otherwise disposed
     of except in compliance with the Act and applicable  state securities laws,
     which restrictions  require the approval of the Company for the transfer of
     any Shares  (which  approval,  except under limited  circumstances,  may be
     withheld by the Company in its sole  discretion).  The undersigned has been
     advised  that the  Company  has no  obligations  to cause the  Shares to be
     registered  under the Act or to comply  with any  exemption  under the Act,
     including but not limited to that set forth in Rule 144  promulgated  under
     the Act, which would permit the Shares to be sold by the  undersigned.  The
     undersigned  understands  that it is anticipated  that there may not be any
     market for resale of the Shares,  and that it may not be  possible  for the
     undersigned  to  liquidate an  investment  in the Shares.  The  undersigned
     understands  the legal  consequences  of the foregoing to mean that he must
     bear the economic risk of his investment in the Shares. He understands that
     any instruments  representing the Shares will bear legends  restricting the
     transfer thereof.

3.   To the extent I have the right to rescind my purchase of the Shares,  which
     right of recission is hereby  offered,  I waive and relinquish  such rights
     and agree to accept certificate(s) evidencing such Shares.

4.   This  Agreement and the rights and  obligations of the parties hereto shall
     be governed by, and construed and enforced in accordance  with, the laws of
     the State of New York.

5.   All pronouns contained herein and any variations thereof shall be deemed to
     refer to the  masculine,  feminine or neuter,  singular  or plural,  as the
     identity of the parties hereto may require.

6.   The  shares  referred  to  herein  may  be  sold  to  the  subscriber  in a
     transaction exempt under Section 517.061 of the Florida Securities Act. The
     shares have not been registered under said act in the State of Florida.  In
     addition,  if  sales  are  made to five or more  persons  in the  State  of
     Florida,  any sale in the State of Florida  is  voidable  by the  purchaser
     within  three (3) days after the first tender of  consideration  is made by
     such purchaser to the issuer, an agent of the issuer, or an escrow agent or
     within  three  (3)  days  after  the  availability  of  that  privilege  is
     communicated to such purchaser, whichever occurs later.

     IN WITNESS WHEREOF,  the undersigned has executed and agrees to be bound by
this  Subscription  Agreement and Investment  Representation on the date written
below as the Date of Subscription:

                         (TO BE USED FOR INDIVIDUAL(S))

     ----------------------------              -----------------------------
     Print Name of Individual                  Signature of Individual

     -----------------------------             -----------------------------
     State of Residence                        Date of Subscription



                   (TO BE USED FOR PARTNERSHIPS, CORPORATIONS,
                            TRUSTS OR OTHER ENTITIES)

    _____________________________       By:_______________________________
    Name of Partnership, Corporation,    Signature of Authorized Representative
    Trust, or Entity

-------------------------------            -------------------------------
Capacity of Authorized Representativ    Print Name of Authorized Representative

-------------------------------            -------------------------
Jurisdiction of Incorporation            Date of Subscription
or Organization