Laser Partners of Oklahoma, Inc. Based in Oklahoma City & Tulsa, Oklahoma Mobile Medical / Aesthetic Laser Equipment Rental Company (P) 1.800.685.9809 (F) 1.800.685.9174 Rentals: rentals@laserpartnersok.com Misc: info@laserpartnersok.com Contact Information Please fill in all information correctly and completely so we may better assist you. Your information is considered confidential and will be used only by us to contact you. It will not be sold or provided to anyone else. I am interested in the following: Send Rental Services information Contact me to schedule a rental Contact me to arrange an in-office demonstration Product / Service of Interest: Laser Hair Removal Fractional Skin Resurfacing Photorejuvenation Tattoo Removal Nail Fungus Body Contouring How did you hear about us?: Referral Laser Sales Rep Physician/Colleague Advertisement Search Engine Friend/Family Company: First Name: Last Name: Specialty: Email: Address: City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: (5 digits) Cell Phone: Office Phone: Fax: Comments:
(P) 1.800.685.9809 (F) 1.800.685.9174 Rentals: rentals@laserpartnersok.com Misc: info@laserpartnersok.com Contact Information Please fill in all information correctly and completely so we may better assist you. Your information is considered confidential and will be used only by us to contact you. It will not be sold or provided to anyone else. I am interested in the following: Send Rental Services information Contact me to schedule a rental Contact me to arrange an in-office demonstration Product / Service of Interest: Laser Hair Removal Fractional Skin Resurfacing Photorejuvenation Tattoo Removal Nail Fungus Body Contouring How did you hear about us?: Referral Laser Sales Rep Physician/Colleague Advertisement Search Engine Friend/Family Company: First Name: Last Name: Specialty: Email: Address: City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: (5 digits) Cell Phone: Office Phone: Fax: Comments:
Rentals: rentals@laserpartnersok.com Misc: info@laserpartnersok.com Contact Information Please fill in all information correctly and completely so we may better assist you. Your information is considered confidential and will be used only by us to contact you. It will not be sold or provided to anyone else. I am interested in the following: Send Rental Services information Contact me to schedule a rental Contact me to arrange an in-office demonstration Product / Service of Interest: Laser Hair Removal Fractional Skin Resurfacing Photorejuvenation Tattoo Removal Nail Fungus Body Contouring How did you hear about us?: Referral Laser Sales Rep Physician/Colleague Advertisement Search Engine Friend/Family Company: First Name: Last Name: Specialty: Email: Address: City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: (5 digits) Cell Phone: Office Phone: Fax: Comments:
Please fill in all information correctly and completely so we may better assist you. Your information is considered confidential and will be used only by us to contact you. It will not be sold or provided to anyone else.
I am interested in the following: