The following forms can be downloaded and printed for your convenience. If you have questions about these forms, please contact Customer Care.
I'd like to...order
The fastest and easiest way to order is to place your order online. If online ordering isn't your style, you can download the order form below, and email fax or mail it to us.
I'd like to... request a credit line
If you're a state government agency or municipality:
State government agencies and municipalities may purchase on open account, pending application.
If you are NOT a state government agency or municipality:
If you are not a federal or state government agency or municipality, you may apply for open account status by completing a Credit Application form.
I'd like to... order medication
Before your agency can order prescription medications from Emergency Medical Products, we must have a completed License Authorization Form (LAF) on file. Learn more.
I'd like to... sign up for electronic invoices
Save the trees, and receive your invoices via email!
Contact Customer Care. if you need additional assistance.