ISO 9001:2000
Orders

Mesurina accepts online orders when you complete this form. Presently, we do not accept payment information via our website. We will, however, contact you to confirm your order and to take any payment information over the phone.

If you have an existing customer account, and wish us to use previous billing arrangements, please indicate in the Additional Information form.

If you prefer a product quotation, please use our Quotations form.

Name:
(required)
Company:
(required)
Address:
(required)
Shipping Address:
(if different)
Phone:
(required)
Fax:
Email:
(must be a valid
email address)
Purchase Order #:
(if available)
Order Details:
(required)
Additional
Information: