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Product ordering instructions.

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First Name *

Last Name *

Business Name *

To order regulated medical devices, and to process your orders without delay, we request that you provide the required business documentation.

Address 1 *

Address 2

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Identification *

Acceptable forms of identification to purchase medical devices are: . State issued document with your organizations Federal Tax ID Number
. City or State issued Business License
. State Department of Health Services License
. Any other ID issued by the State that includes the business name and address

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