Lease Dental Equipment Please fill out the form and submit it to initiate the lease process. Thank you for choosing us as your dental supplies provider. We aim to fulfill your requirements promptly and efficiently.Please enable JavaScript in your browser to complete this form.Name *FirstLastCompany NameEmail *EmailConfirm EmailPhone Number *Interested in Leasing... (Select all that apply) *Medical Furniture (Chairs, Stools, & Oral Surgery Tables)Medical CabinetsX-Ray MachinesMechanical Room (Air Compressors, Amalgam Separators, Vacuum, etc...)Delivery Units (Syringes, Suction, Air, Water, etc...)Medical / Delivery CartsLighting (Ceiling Mounted, Post Mounted, Head Worn, etc...)Instruments (Forceps, Scalers, Mirrors, etc..)Small Equipment (Curing Lights, Vibrating Table, Handpieces)Ultrasonic Cleaners, Sterlizers, Autoclaves, etc...Lab Equipment (Artiulator, Impressions, etc...)Other (Not Listed)Budget *Up to $5,000$5,000 - $15,000$15,000 - $25,000$25,000 - $50,000$50,000 - $75,000$75,000 and $100,000$100,000 and UpDelivery? *Yes, I will need a shipping quote.No, I will pickup for free!Zip Code*Required If "Yes" is selected.Installation? *Yes, I will need equipment installedUnsure, I would like information.No, I have hired someone else.Comment or MessageSubmit
