Click the buttons below to download .pdf file of forms you may print out, complete and mail or fax to us

 

Prescription Drug Authorization form

To purchase prescription pharmaceuticals,plese complete this form and email or fax back to us. Download form

 

Credit Application Form

To open a SLI Medical line of credit,please complete this form and mail or fax back to us. Download form

 

Authorization to Purchase- Public Sector

For public sector organizations only (i.e Government, Corrections and Schools). Complete and return this form to confirm a request to open an account for your organization. Download form

 

Prescription Drug Return Authorization Form

All requested to return prescription drugs must be approved by cutomer services within 7 days of invoice and the product(S) returned to us within 15 days accompanied by this signed form Download form

 

Methamphetamine control Act-Pseudophedire Form

The Methamphetamine control Act of 1997 regulates the distribution of all list I Chemicals (all product containing Pseudophedire). The attached letter certifies that your use of these product is in direct compliance with this act. Download form

 

Controlled Substance Customer Questionnaire

Require for the purchase of all controlled substances Download form

 

Florida sole Proprietor Letter

The Florida cutomers only.This form is needed to determined if a cutomer is a sole Proprietor.If the customer is not a sole proprietor,an HCCE permit is required. Download form

 

Ohio Sole Proprietor Letter

For ohio cutomers only..This form is needed to determine if a cutomer is a sole Proprietor.If the customer is not a sole Proprietor ,a Terminal Distributor of Dangerous Drugs (TDDD) license is required. Download form