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Blue Wave Medical - Carestart Covid-19 Test Kits Request For Quote
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Enter Quantity of Tests for Quote
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Test Kit Packaging Dimensions
Need by Date. Please enter a date as MM-DD-YYYY
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Buyer/Company Name
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Contact Full Name & Title
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Contact Phone Number
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Company Address - Provide complete address.
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Shipping Preference - please indicate one. (A) Buyer to provide own shipping & Bill of Lading. (B) Seller to coordinate & add shipping fees to order separately. (C) Other - Please explain.
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Ship To Address - Provide complete address (street, city, zip).
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Ship-To Contact Name & Title
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Ship-To Contact Email & Phone Number
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Required Documents - To be provided at time of Order. Please indicate which will apply. (A) CLIA Waiver Certificate [Medical end-buyer] (B) IRS Form W-9 [Buyer & End-buyer] (C) Wholesaler Certificate [if applicable]
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Authorized Signer/Buyer Name & Title
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Thank you for your request. We will email you a quote shortly. Please feel free to send any comments below.
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