Purchase Order

Please note: this is a purchase order submission form. You must have an active Neotech account with terms to submit a purchase order. If you do not have an account or you cannot recall your account number, please call the number below.

Your purchase order will be confirmed by a Neotech Customer Service Representative via fax, phone or email. If you do not receive confirmation or have any questions concerning your order, please contact us at 1-800-966-0500 or 1-661-775-7466. You may also email orders@neotechproducts.com.

U.S. orders received by 2:00 PM PST generally ship the same day. If next day delivery is critical, please contact us at 1-800-966-0500.

By submitting your purchase order, you agree to our Terms & Conditions.

Account Information
Date 03/25/2025
Account Number*
Name*
First Last
PO Number*
Phone*
Fax
Email*
Order Details
Upload your PO here:
Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 5 MB.
If you don’t have a PO, click here to enter your order manually:
- Enter Manually
Enter order below; click +/- to add or delete line items.
Quantity Catalog # Price

Prices will be confirmed by a Neotech Customer Service Representative.
Do you have a promo code?
Promo/Coupon Code
Shipping Information
Hospital/Company Name*
Attn:
Ship to*
Street Address Address Line 2
City*
City
State & Zip Code*
State ZIP Code
Billing Information
Billing Address
- Same as Shipping Address
Billing Center Name
Attn:
Bill to*
Street Address Address Line 2
City*
City
State & Zip Code*
State ZIP Code
Shipping Payment Option
Shipping Payment Option*
- Prepay and Add (U.S. Only)
- 3rd Party Billing (U.S. Only)
- International Shipping
3rd Party Shipping Carrier
- UPS
- FedEx
UPS Shipping Method*
UPS Account Number*
FedEx Shipping Method*
FedEx Account Number*
Customer Notes
Please note: this is a purchase order submission form. You must have an active Neotech account with terms to submit a purchase order. If you do not have an account or you cannot recall your account number, please call the number below.

Your purchase order will be confirmed by a Neotech Customer Service Representative via fax, phone or email. If you do not receive confirmation or have any questions concerning your order, please contact us at 1-800-966-0500 or 1-661-775-7466. You may also email orders@neotechproducts.com.

U.S. orders received by 2:00 PM PST generally ship the same day. If next day delivery is critical, please contact us at 1-800-966-0500.

By submitting your purchase order, you agree to our Terms & Conditions.
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Shopping Cart

Purchase Order

Account Information

Order Details

Do you have a promo code?

Shipping Information

Billing Information

Shipping Payment Option

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Quantity	Catalog #	Price