Request a Sample/Product Order Form - Patient ProGuard - Hospital and Medical Disposable Covers

Patient ProGuard

Request a Sample/Product Order Form

To order one of our FREE* Sample Packs or to place an order for any of our products you can contact us directly at:

Patient ProGuard
P.O. Box 114
Owensville, OH 45160

Phone: (513) 732-0531
Fax: (513) 732-0627

or fill out the form below:

Your Name:*

Company/Organization:*

Department:*

Address:*

City:*

State:*

ZIP:*

Phone Number:*

Email Address:*

For a FREE Sample Pack, please select all that apply:

Pillow Speakers Covers TV Remote Covers

What is your current Model/Brand of Pillow Speakers/Remotes?

Questions
or Requests:

Security Code:*

Re-type the Code here

*- Indicates required fields.