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Field Access - Online Order Form

PLEASE USE THE FOLLOWING FORM TO SUBMIT ONLINE PURCHASE ORDERS. ONLY USE THIS FORM IF YOU DO NOT HAVE ANY OTHER METHOD OF SENDING A PURCHASE ORDER TO OUR OFFICE.  

 

ALL ORDERS WILL BE CONFIRMED WITH THE INFORMATION PROVIDED TO COMPLETE THE ORDER PROCESS ONCE PLACED. YOU MUST HAVE AN ACTIVE QUOTATION PLACED IN OUR SYSTEM TO USE THE FOLLOWING FORM TO PLACE AN ORDER AS WELL AS A NET 30 ACCOUNT IN GOOD STANDING. ALL ORDERS ARE SUBJECT TO CONDITIONS OF ORDER PLACEMENT VIA COMPANY POLICY AND ACCOUNT STATUS. IF YOU DO NOT HAVE AN ACTIVE QUOTATION PLEASE CALL OUR OFFICE TO PLACE A REQUEST FOR A QUOTATION. QUOTATIONS ARE GOOD FOR 30 DAYS. IF YOU DO NOT HAVE AN ACCOUNT, YOU MUST SET UP AN ACCOUNT WITH OUR OFFICE FIRST BEFORE PLACING AN ORDER. PLEASE CALL US WITH ANY QUESTIONS: 951-742-7020.

 

*NOTE: BY CLICKING ON "SEND" YOU ARE HEREBY AFFIRMING YOU HAVE THE AUTHORITY TO PLACE AN ORDER IN CONJUNCTION WITH THE QUOTATION AS STATED FOR THE ORDERING COMPANY / CLIENT.

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Notice of Non-Affiliation and Disclaimer

Neomed Imaging, LLC is not affiliated, associated, authorized, endorsed by, or in any way officially connected with Ziehm-Orthoscan, Inc, or any of its subsidiaries or its affiliates. The official Ziehm-Orthoscan website can be found at: http://ziehm-orthoscan.com. The official Ziehm Imaging website can be found at: http://www.ziehm.com.

The names Ziehm, Ziehm Imaging, and Ziehm-Orthoscan as well as related names, marks, emblems and images are registered trademarks of Ziehm-Orthoscan, Inc. The use of any trade name or trademark is for identification and reference purposes only, and does not imply any association with Ziehm-Orthoscan, Inc or their product brand.

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