Free Product Request Form - uoftmedstorecom 2026

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The document is a request form for obtaining free promotional items from BioRad. It provides instructions to submit the completed form via fax or email, and includes fields for personal and institutional information, as well as details about the requested item.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Medstore Receipt number in the designated field. This is essential for processing your request.
In the 'Free item # requested' section, specify the promotional item you wish to receive. Ensure accuracy to avoid delays.
Fill in the 'Ship to Address' fields, including your contact name (first and last), institute, department, room number, and postal code.
Provide your email address for confirmation and updates regarding your request.
Lastly, add any comments or special instructions in the comments section before submitting your form.

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2010	4.9 Satisfied (57 Votes)

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