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Introduce Your Company


Thank you for filling in the following form to introduce your company for our mutual understanding.
We will sincerely review your information and contact you soonest possible.

Please fill in the fields as full as possible.

Company Name:
Company Address:
Country:
E-mail:
Telephone No.:
Contact Person:
Title:
Web Site:
Business Operation: Pain Management
Chiropractic
Physical Therapy
Sports Medicine
Dermatology
Hair Loss Treatment
Dentistry
Others
Other Medical Market:
Other Non-medical Market:
Years in Business:
Who do you represent as distributor?
Do you have service team? Yes
No
Number of Salesmen:
Number of Resellers/Whosalers:
Additional Company Information:
Your Comments and Questions:

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