Health Management Systems, Corp.

888-300-4672         

We offer the highest quality products for Point-of Care Testing!

 

  Request a Quote
  

If you would like to have a quote e-mailed to you, please submit the following form and we will respond within 24 hours.

USE THE TAB OR MOUSE, NOT THE ENTER KEY, TO MOVE BETWEEN FIELDS.  The enter key will submit the form.  If you hit the enter key prior to completion of the form, use your back button and continue filling out the form.  Click submit or Enter when done.

If you are a current customer, please enter your customer # and you may skip the billing and shipping portion of this form.
 

Company Name:
Contact Name:

Address 1:

Address 2:

City:

State:                     Zip:
    
Company Name:
Contact Name:

Address 1:

Address 2:

City:

State:                    Zip:
    

Name of Person requesting quote:

E-mail address:

Phone number:

Fax Number:

Date Product Required by:

HMSC Sales Rep:
 

Quantity

Part#

Description

If you are requesting a quote for Cholestech Cassettes, please estimate your annual volume in boxes  (10 tests per box)

Lipid or Lipid+Glucose
TC/HDL or TC/HDL+Glucose
TC+Glucose
ALT/AST
hs-CRP

    


If you have any questions or problems with this site, please call Health Management Systems, Corp. customer service at 888-300-4672