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CUSTOMER APPLICATION
FAQ
The difference between the healthcare company that succeeds and the one that fails depends in part on the decisions they make every day. One thing that can distinguish your company as one that succeeds is the decision you make about procurement. We hope you’ll decide to add your company to the host of other CERES customers benefiting from our Quality, Service and Price.

Please complete these two forms and take the first step toward becoming a CERES customer.
Participation Document     Implementation Form
Contact Information Date: 1/5/2009
Facility Type*: 
Facility Name*: 
Mailing Address*: 
 
City*: 
State*: 
Zip*:  
Contact First Name*: 
Contact Last Name*: 
Phone*:  
Fax*:  
Email*:  
Licensed Beds*: 
Facility Ownership*: 

Supplier Information
Other Products:

Do you certify that all information listed on this form to be correct and true?*  
Authorized Signature*: 
Title*: 

Note An asterisk (*) denotes a required field.
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