Medex® Supply Order Process

1. Download and print supply order form pdf.

2. Complete order form in its entirety.

  • Buyers Name – Required
  • Facility Name – Required
  • Physical address – Required (address where supplies will ship to)
  • Contact phone number – Required
  • Inmar account number – Required
  • Ship to Attn: – Required
  • Need by date – Required
  • Purchase Order Number (If applicable)
  • CAP credits if available checkbox (If using CAP credits to purchase supplies)
  • Shipping Carrier (FedEx, UPS, etc. only used when supplies will be shipped using the clients shipping account)
  • Shipping Carrier account number (only used when supplies will be shipped using the clients shipping account)
  • Select appropriate supplies and quantities. – Required
  • Applicable sales tax % – Required (based on sales tax rate per location)

3. Place Order – Fax or scan/email order form. (email is preferred delivery)