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Calipers — Quotation Request

Please fill out the following form as accurately and completely as possible to receive a written quotation on Calipers.


I Would Like To Receive:
Product Literature
Written Quotation


Please send specific information for:
Radiotherapy simulators
Shielding block cutters
Beam compensator milling systems
X-ray cassette holders
Breast incline board
Radiotherapy thermoplastic
Calipers
Head & neck immobilization
Foam blocks, alloy, other supplies


I'm also interested in receiving a complete information package for:
Radiotherapy product line
Remanufactured diagnostic imaging systems
X-ray collimators

(list additional interests in text box provided below)


My Personal Information:

First Name

Last Name

Middle Initial

Title

Organization

Work Phone

Fax

E-mail Address (required)

Street Address

City

State

Zip Code

Country


Contact Details

The above information is also my “ship to” address:
yes no (If no, please provide “ship to” in text box provided below)

Please contact me via:

I would also like someone to call me:
yes no


Quote Item 1

Please enter quantity and select Calipers model.
(enter qty.)
Standard Body Calipers, measures 0—45 cm (CA-45-1)
Extended Body Calipers, measures 0—55 cm (CA-55-1)
Head and Neck Calipers, measures 0—25 cm (CA-25-1)


Additional quote items or comments may be listed in the text box provided below.
Other:

I first learned of Huestis Medical from:

Ad Article Press Release


Trade Show


Other


Additional Comments


 

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© 2001 Huestis Medical. All rights reserved. Specifications subject to change without notice.
Please contact us at 401.253.5500 (M-F, 8:00 am-5:00 pm, EST, USA) or sales@huestis.com for sales or technical assistance.