Meyer Distributing Company: Account Request

This is a business-to-business website. If you are seeking products for personal use, please consult your local chiropractic, acupuncture, massage therapy, podiatry or physical therapy clinic.

Enter your information to have a Meyer Distributing Company representative contact you about establishing an account. The information you provide in this form will NOT BE SHARED with anyone outside Meyer Distributing Company.

* Required fields.

Step 1: Fill in your contact information.
First Name*:
Last Name*:
Company Name*:
Address:
Town/City:	State:	Zip Code:
Phone*:	Ext:
E-mail*:	Fax:

Step 2: What brought you to our website?
Search Engine
Link from another Website
Referral from a Friend or Colleague
Trade Show
Magazine Ad:
Printed Catalog or Flyer
Other:

Step 3: Tell us about your business.
What is the primary focus of your business? Chiropractic Acupuncture Massage Therapy Podiatry Physical Therapy
Number of Locations:

Comments or Questions:

Step 4: Submit your request.

1810 Summit Commerce Park | Twinsburg, OH 44087 | Phone: 1.800.472.4221 | Fax: 1.800.577.4632

Meyer Distributing Company provides a complete selection of Massage Tables, Traction Tables, Physical Therapy Tables, Modalities, Massage Products, X-Ray Film and Accessories, Diagnostics, Traction, Hot/Cold Therapy, Treatment Supplies, Pillows, Slings & Cervical Collars, Back Supports, Orthopedic Extremities, Rehabilitation and Exercise, Acupuncture Supplies, Magnetic Therapy, Vitamins & Nutritional products. © 2004 Meyer Distributing Company – All Rights Reserved | Legal / Privacy / HIPAA Information W4

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