Request Form

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

You can contact us by mail, phone or the internet:

Medical Imaging Technologies, Inc.
P.O. Box 2145
Hudson, OH 44236
P: (888) 298-1207
F: (330) 633-7886
info@medimagetec.com

Name:	*
Address:	*
City:	*
State:	*
Zip:	*

Phone:	*
Fax:
Email:	*

I am interested in? ^{Check all that apply}	Gamma Camera/Computer Service Accessories

Comments:
How did you hear about us?
^{* denotes required items}