This form can be filled out online, printed and faxed to our office for prompt and secure processing of your order.
You will be notified by phone and/or email regarding the order, availability of the equipment and shipping
related information (cost, expected date of delivery, etc.). Our fax equipment is in a secure location and
online 24 hours a day, your confidential information will not be accessible to any unauthorized personnel.
Thank you in advance for your order, we will do our best to satisfy your needs.