Sonoran Medical Resources, LLC

Equipment To Sell form:

Fields marked with an asterisk (*) are required.

First Name:

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Last Name:

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Company:

Address:

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City:

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State:

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Zip:

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Phone:

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Fax:

Email:

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Type of Equipment:

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Manufacturer:

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Model:

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Equipment Age:

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Date of Availability:

Month:

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Day:

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Year:

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Condition of Equipment:

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Asking Price:

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Equipment To Buy Form:
Please fill out the information below to better assist us in helping you find the equipment you need.

Fields marked with an asterisk (*) are required.

First Name:

*

Last Name:

*

Company:

Phone:

*

Fax:

Email:

*

Type of Equipment:(ex. MRI, CT, Ultrasound)

*

Age range desired:

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Special Options you require:

When will you need the equipment:

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Manufacturers or models desired: