Lazarus 3D PPE Order
Please fill out this form below in order to secure the quantity you need.
NOTE: AT THIS TIME, WE ARE ONLY TAKING REQUESTS FROM MEDICAL AND CRITICAL CARE SERVICE PROVIDERS. WE ARE MANUFACTURING THE PRODUCTS DIRECTLY, NOT RE-SELLING. PLEASE VISIT
FOR MORE INFORMATION.
Name of organization
Please enter full address: street, city, zip code
Will Pick-Up or arrange a Pick-up (Lazarus 3D: 7523 South Freeway, Houston, TX 77021)
Add shipping charges to my order
Use my Carrier Account Number
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