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"Interested in reselling teD Product Suite?" 

Please complete the reseller profile and we will be in touch with you shortly.
We provide quality training and support to our partners.
Company Name :  
Address :
City :   State :   Zip : 
D & B # :
CONTACT
Name :
Phone :  Fax :     Cell :
E-mail :    
Briefly describe the history of
your company :
Briefly explain your experience in
health care industry :
Please describe the products
that you sell :
Please describe the services
that you sell :
Please list the business locations
( If more than one ) :
PLEASE PROVIDE TWO TRADE REFERENCES
Company 1 :
Address :
City :   State :   Zip :  
Phone :   Fax :     Cell : 
E-mail :  
Company 2 
Address :
City :   State :   Zip :  
Phone :   Fax :     Cell : 
E-mail :