Quote Request Form for International Customers

International Quote Request

Dear Client,

Thank you for visiting medicaleshop.com

Please submit complete details in order to receive an accurate quote and more details will allow us to effectively communicate with you to help with your products and special pricing needs. (*Manufacturer/Brands restrictions may apply)

First Name

Last Name

Telephone

Job Title/Position

Company/Facility Name

Select Country

Zip Code

Enter State/Province/District

Address Line 1

Address Line 2

City

Enter Product Name /Model # (Required)

Enter Product Name 2 /Model# (Optional)

Enter Product Name 3 /Model# (Optional)

Quote details (Please enter any product options/accessories required)

Upload an Image / Pdf / File :

* Required Fields

CUSTOMER SERVICE

Medicaleshop Inc

Phone: (866) 563-6812
Mon-Fri, 8.30am to 5pm EST
Fax: (860) 838 4671

OUR RETAIL STORES

Newburgh, New York
5027 Route 9 W
Newburgh, NY 12550

New Milford, Connecticut
87 Danbury Road, Unit I
New Milford, CT 06776

International Quote Request

CUSTOMER SERVICE

OUR RETAIL STORES

My Account

Medicaleshop

Our Location

Exclusive Program