Request For Quote

2012

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2012


	Request for Quote form: If your medical or government or educational facility requires the use of Purchase orders, please fill out the form below. We require a faxed copy of a purchase order with your facility's letterhead on the document to consider opening an account. FAX No. 609-242-3932 CINTECH INC can also provide quotes for many items not listed on our web site including: Bariatric Tables & Equipment "Wheelchair Accessible" Power Exam & Treatment Tables Pediatric Exam & Treatment Tables Specialty & Taping Tables Chromeware, Gel Pads, Cushions, Therapy & ReHab Equipment and more! * denotes required field Your Name:* First Last Contact Info:* E-Mail: Phone: Fax: Company or Facility Name: Name of Company or Facility City State Job Title Does Your Facility Use Purchase Orders?* Yes No Type of Product you are interested in: Medical Lamps & Lighting Exam & Treatment Tables Specialty Chairs & Stools Surgical Table Accessories: cushions, pads, armboards, etc. Surgical Table Repair Parts I.V. Poles & Accessories Other Please list details of item(s) requiring quote:* 3000 characters remaining Enter the code shown:

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