Leave this field blank International Distributor Questionnaire * Required Fields * Contact Name * Phone Number * Email * In what countries does your company operate and sell products? If your company is a hospital or dialysis clinic, please provide details. * What is the name of your company (include your company Web site address)? * How many years have you been in the dialysis business (provide business references)? If you are not in the dialysis business, what is the nature of your business? * What is your ship to address? * What are the complete names of the principals in the company? * What is your company's yearly sales revenue? * What medical product areas do you specialize in? * What dialysis products do you currently sell? * Can you work with Word (.doc) and Adobe (.pdf) file attachments via email? For all international customers, RPC requires payment in US dollars, via wire transfer, in advance of each order shipment.
