EMSAR New Customer Set Up Form

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EMSAR offers a wide range of healthcare, kiosk, and security support services including: Repairs, Calibration, Preventative Maintenance, Annual Service Contracts, Project Management and Asset Management Services. In order to best support you, please complete the form below so that we may setup your account in our system and provide our rates and terms. This form is routed directly to our Dispatch department who will follow up with you to answer questions or setup a service request.

    Are you an existing EMSAR customer?

    Sales Tax Exempt

    Tax Exemption Form

    Payment Method

    PO Required?

    Current EMSAR Service Contract

    Depend On Us.

    Contact Info

    Ohio Headquarters:
    270 Davids Drive
    Wilmington, OH 45177
    Phone: 800-733-6727
    Parts: 800-733-6727 x1005

     
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