The confidential information we are requesting below is to verify that you are indeed a Health Care Professional.
This form is to only give you access to the Professional section of our website. In order to place orders with Professional pricing, you must fill in the Application form and return it to us. Upon receipt of your completed application form, all information provided will be verified. New accounts will be processed within 2 business days.
***Our Catalog, Price List & Application Form can be downloaded directly from our website under the professional section/ Product Catalog.