Get Synchromed Ii Pump Order Form - Medtronicretireecom

Filling out the SYNCHROMED II Pump Order Form is a straightforward process that ensures your medical equipment needs are met efficiently. This guide provides a step-by-step breakdown to assist users in completing the form correctly and effectively.

Follow the steps to successfully complete the order form.

1. Press the ‘Get Form’ button to access the SYNCHROMED II Pump Order Form and open it in your document editor.
2. Fill in the hospital, clinic, or distributor name along with the complete address including city, postal code, district or province, and country where the pump is to be delivered.
3. Indicate the desired delivery date and, if necessary, the delivery time in the appropriate fields.
4. Select the order type by checking one of the options: "Hospital / Clinic / Distributor Purchase" or "Hospital / Clinic Consignment." If purchasing, provide the purchase order number.
5. Specify the quantity of pumps required and indicate the specific type: either 20 mL or 40 mL.
6. If shipping directly to a Medtronic representative, include their name or account number. It is important to confirm the delivery date with the Medtronic representative.
7. If there are any special instructions, additional products to be ordered, or specific attention required for shipping, note these in the designated optional fields.
8. Provide the physician’s email address in the optional field, as well as any carrier preference if applicable.
9. Once all required fields are filled, ensure all information is accurate. Users should then save the changes to the order form.
10. Print a copy of the completed form or share it electronically, and submit the order form along with a signed certificate to Medtronic Customer Service via fax or scanned email.

Complete your forms online efficiently and ensure all necessary information is submitted accurately.