Order Form

Section Contents

 

Catalog

 

This catalog constitutes all products sold by CareTRAC

 

Order Form

 

This order form is designed to allow you to quickly order product electronically.

 

FAQ

 

Refer to the frequently asked question section for the latest solutions to commonly asked questions

Order Information
Phone: (614) 882-1040
Fax: Print this form and fax it to: (614) 882-1025
Mail to:CareTRAC.com

Send this form to:

CareTRAC, 5075 Westerville Road., Columbus, Ohio, 43231-4909

Terms & Conditions
C.O.D./Net 30 with pre approved credit/Leasing

Shipping Information
Returns for repair or exchange only with pre approved RMA numbers
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Order Form

Item #

Description

Price

Qty.

Subtotal.

Tax.

Total.

Total.
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Shipping address

Name

Company

City

Country

E-mail

Name

Company

City

Country

E-mail

Credit Card

Cardholder Name

Card Number

Expiration

State

Zip
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Billing address

 Check if same as shipping address

State

Zip
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Billing Information
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