- Complete the boxes at the top of the
Order Form and Rental Agreement with the desired product(s)
and accessories. Include price, tax, freight and totals. Contact Customer Service
to get freight charges and help with tax rates.
- Complete the "Date that Product is Needed" section. Because of the limited availability
of some products, we will make every reasonable attempt to accommodate your schedule.
- Complete the "Bill To" and "Ship To" boxes. If they are the same, write "Same"
in the "Ship To" box.
- Select a Method of Payment. Payment must be received with the Order Form and Rental Agreement.
If products are funded by Medical Assistance, include any applicable deductible payment.
- Sign the Order Form and Rental Agreement and send it to ZYGO by
fax (503) 684-6011 or mail it to P.O. Box 1008, Portland, OR 97207-1008. You can also e-mail a PDF of
the signed form to [email protected].
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