First Name *
Last Name *
Company *
Professionnal Email *
Professionnal Phone Number *
Industry *
Aerospace
Athletic Therapy
Automotive
Cannabis
Charity
Convenient Stores
Cosmetic
Dental Clinic
Dental Equipment Distribution
Dental schools
Dental Service Organization
Department Stores
Food Service
Government
Grocery Stores
Hair
Hardware Stores
Health & Safety
Home Care
Hospital
Industrial Equipment Distribution
Janitorial Sanitation
Manufacturing
Medical Clinic
Medical Equipment Distribution
Online Retail
Paramedical
Pedicure/Manicure
Pharmacy
Public Services
Rental Stores
Scientific & Research
Tattoo
Veterinary
Wholesale
Province *
AB
BC
MB
NB
NF
NS
NT
NU
ON
PE
QC
SK
YT
USA
Is this inquiry for everyday usage or for resell purposes? *
Everyday usage in your company
Resell purposes
Usage at home
What kind of products do you want samples for?
Nitrile Gloves
Latex Gloves
Vinyl Gloves
Face Masks ASTM 1-2-3
Sanitation Supplies
Sterilization Pouches & CSR Wraps
Other Disposable Protection Products
How often do you usually purchase disposable products for your company?
Weekly
Monthly
Quarterly
Annually
What volume of Aurelia products would you usually be looking for in a single order?
Less than 50 boxes per order (e.g. less than 5,000 gloves)
Between 50 and 500 boxes per order (e.g. between 5,000 and 50,000 gloves)
Over 500 boxes per order (e.g. over 50,000 gloves)
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