Cart Fair/Trade Show Equipment Request Form
(Only 1 cart per request)

( * ) Indicates required field
* Sales Rep Requesting
* Sales Rep's email address
Event Information

  • * Name
  • * Date of Event
  • * Date Needed to Arrive
Shipping Information
  • * Picking up or shipping?
  • * Ship to (Facility)
  • * Contact's Name
  • * Contact's Phone Number
  • * Shipping Address
  • *Lift Gate Required (Y or N)
  • * Estimated Date of Return
Cart Information
All HI-Care based carts are white/grey with 5" casters unless specified.
Monitor measures up to 22" unless specified.
  • * Cart Needed:
  • CPU:
  • Monitor:
  • Peripherals:
  • Accessory mounting options:
  • Pole with mounting bracket
  • Extended Mounting Bracket
           Not compatible with HI-Care general storage drawer or HI-Paradigm.
  • Accessories:
  • Sani wipes Mini waste Basic Accessory Pack
    Includes pole, extended
    mounting bracket, Sani-
    wipes, bracket,1 QT
    sharps container, Mini
    waste bin, Small basket,
    and Hand Sanitizer
  • Hand sanitizer Small basket
  • Sharps 1 QT Large basket
  • Sharps 2 QT
Additional comments about Shipping
Additional comments about Cart, Drawer Configuration, Power System:


Marketing Materials Quantity
* Shipping to same Location as above

Flooring
Tablecloth(s)
Pop-up Banner Stand
Givaways

Additional comments about Marketing Materials


Brochures
HI-Mobile HI-Paradigm
HI-Care HI-Pinnacle
HI-Prodigy Tri-fold Folder
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