Name
Address 1
(workplace preferred)
Address 2
Dept./Room
City
State
Zip Code
e-mail
How did you first hear
about our products?
Web Ad
Mailer
Journal ad
Conference exhibit booth
Use(d) them at another facility
Colleague recommendation
Textbook
Internet
Wound care symposium
Other
Please send me
samples of:
SUPER
SHIELD
KLENZALAC ultimate wound irrigation system
Comments / Questions
or call
1 (800) 438-0938
1(800) GET - "0" - WET
ZEROWET
P.O. Box 4375
Palos Verdes Peninsula, CA 90274
Telephone: (310) 544-1600 - Facsimile: (310) 544-4411
1-800-438-0938