Philly Hand 2022 Lead Card

Name *

Title *

Email *

Phone Number *

Facility Name *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Do you have a preferred vendor source for your most commonly ordered products? *

YesNo

Are you the person to contact regarding qualifying products in your practice or facility? *

YesNo

If yes, who is your preferred vendor?

If no, please let us know who the contact is

Do you currently retail any products and supplies to your patients? *

YesNo

If Yes, what type or brand of products do you retail?

Considering the products shown at our booth, which one/s would you be interested in purchasing? *

Comfort Cool GladiatorThermoplasticsFEPSimOrfit ProductsNorco Heavy Compression GlovesGrippy Non-Slip MaterialSplinting: Strava | Splint-Form 1000ActivaPatch | Trivarion | ActivaDose IINorco Buffered Iotophoretic Delivery KitNorco Multi-Use ElectrodesNorco Eco-Stim TENS+EMS | Norco Eco-Stim Electrodes

Comments and General Feedback

Philadelphia Hand 2022 Lead Card Form

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Hand Therapy

Physical Therapy

Occupational Therapy

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