Customer Set Up Form

Please fill out all information below in its entirety as it is required to set up your customer account.

Billing Address

Clinic Name*

Address*

City

Province

Postal Code

Phone Number*

Contact Name*

Email*

Shipping Address (If the same as billing address, select box here)

Clinic Name

Address

City

Province

Postal Code

Phone Number

Contact Name

Credit Card Information

Credit Card Number

Expiry Date

CVV

Name

Address

Kept on File

Quote Number

Sales Representative

Training

If the above contact information is not for the individual receiving training, please complete the following:

Trainee Full Name

Trainee Email

Name

Date

Commercial Terms & Shipping Policy

Salient Medical ships orders within Canada only. All orders are shipped Monday to Friday within 3 business days, with exceptions. All packages are shipped via UPS, and require a signature upon delivery. Depending on your location in Canada, estimated delivery is between 1-4 business days. All orders require a full shipping address to process (no PO Boxes).

All Sales of equipment are final. Defective or otherwise nonconforming product is subject to return pursuant to RMA authorization. A return material authorization (RMA) must be obtained from Salient Customer Service or a Sales Representative for any and all returns.

Specialties

Technologies

Skin Science Categories

Products

Indication

Technologies

Air Purifications Solutions

Technologies