Product Display Kit Order Form

Product Display Kit

DoseLogix is happy to send you a FREE Product Display Kit for you to use at an Industry Exhibit. This Display Kit gives you the opportunity to share innovations in topical dosing with your customers. Each Display Kit will include an assembled Display Kit with your Logo on a label in the top right corner, samples of pre-filled Topi-CLICK products, and a portfolio with order forms.

I am a...*

Distributor
Pharmacy

Contact Name*

First Last

Contact Email*

Company Name*

Company Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone*

Upload your Logo File*

Accepted file types: jpg, png, pdf, ai, Max. file size: 32 MB.

Your logo will adhere to the Display Kit on a 2x4" label in the top right corner of the Display Kit.

Exhibit Information

Please enter the following exhibit information. This information will be used to verify your show attendance in order to process your reimbursement.

Exhibit Name*

Exhibit Location*

City State / Province / Region

Exhibit Start Date*

Exhibit Booth #*

Shipping Information

Product Display Kits will be shipped directly from DoseLogix to the Hotel of your choice. We ask that you place your order for the Display Kit at least 7 business days before your representative plans to arrive at the hotel.

Hotel Name*

Hotel Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Hotel Phone*

Delivery Date*

Please select the date the Display Kit should be delivered on. Usually, this is the date that your representative is arriving at the hotel, one to two days before the exhibit opens.

Pick-up Person's Name*

First Last

Pick-up Person's Email*

For delivery notification purposes.

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