Medical exam table paper order form

Medical exam table paper order form
Please complete this form to order exam table paper supplies for your clinic or facility.
Full name
First NameLast Name
Organization or clinic name
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Shipping address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Select exam table paper product(s) to order
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Standard 18" x 225' 1-ply exam table paper
18 inches wide, 225 feet long, 1-ply, white. 12 rolls per case.
$39.99Quantity

Standard 21" x 225' 1-ply exam table paper
21 inches wide, 225 feet long, 1-ply, white. 12 rolls per case.
$44.99Quantity

Premium crepe 18" x 125' 2-ply exam table paper
18 inches wide, 125 feet long, 2-ply, crepe texture. 12 rolls per case.
$54.99Quantity

Premium crepe 21" x 125' 2-ply exam table paper
21 inches wide, 125 feet long, 2-ply, crepe texture. 12 rolls per case.
$59.99Quantity

Eco-friendly 18" x 225' exam table paper
18 inches wide, 225 feet long, made from recycled materials. 12 rolls per case.
$49.99Quantity

Eco-friendly 21" x 225' exam table paper
21 inches wide, 225 feet long, made from recycled materials. 12 rolls per case.
$54.99Quantity

Total
$0.00
Preferred delivery date
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Date
Purchase order number (if applicable)
Contact method for order updates
Special delivery instructions or notes
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