inDisposables
 
Request a Catalog
Request a Catalog
View Catalog
View Our Specials
Place Your Order
Company/Shipping Info
Contact Us
Please Call Beck-Lee to have your account information setup & obtain a customer account number at 800-235-2852. Or fill out the New Customer Application Form below and submit.

New Customer Application Form
* Required fields

*Account Name
*Medical Specialty
*Address
Address 2
Suite No.
*City
*State *Zip:
*Telephone
*Fax Number
*Buyers (first name only)
Email Address
DEA Registration No.
DEA Expiration Date
State License Number
 
Please be certain that we have a copy of your D.E.A. License for verification. D.E.A. controlled drugs cannot be shipped without verification and can only be shipped to the address shown on the D.E.A. License

Terms Requested:
Bill Me Credit Card

Credit Card Type:
Visa
MasterCard
American Express

Credit Card Number

Expiration Date

C.O.D.

Shipping Information:
Same as Above Ship to Address Below

Shipping Via:
UPS Ground US Priority Mail
Special Instructions
 

Your request will be processed immediately.

inDisposables
Phone 1-800-269-4568
Fax 1-800-525-4568