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Order Form

Our fillable order form can be found here!

Simply complete the Order Form and submit via email to order@universalmedicalinc.com or via Fax to 800-535-6229!*

Please note, if you are paying by credit card, it is recommended that you proceed with your purchase online for security purposes.

*Already have a system generated PO from your internal procurement system?   If so, that may be submitted directly to our Order Processing department, completing an Order Form is only necessary for making a purchase without a facility PO.