For Medical Supplies
and Equipment Call Today!
1-800-899-8741
Log In:
Please complete this form to help us serve you better!
1. Enter your facility information:
Are you already a Tri-State Customer?  Yes  No

At this time, the Tri-State Surgical online ordering system is only avaliable to healthcare facilities or supply distributors.

For additional information, please call 1800-899-8741
Facility Name:*
Type of facility:
Other:
Facility Size/Bed Count:
Street Address:*
City:*
State:*
Zip:*
Please enter the name of your Tri-State Surgical Representative (if applicable)
2. Enter your contact information:
Contact Name:*

Contact Position:*
Email:

Telephone:*
Please check the status that applies to you
I can decide on which vendors our facility uses
I have no restrictions on which vendor I place orders with
My orders may need pre-approval depending on dollar amount
I can place orders from pre-approved vendors
I order MOST of my facilities supplies/equipment online
I order SOME of my facilities supplies/equipment online
I RARELY order my facilities supplies/equipment online
I place routine orders for durable medical equipment
I place routine orders for medical suppliers
3. Enter your group details:
Are you part of a group purchasing organization?  Yes No
Group Name(s):

Are you part of a multi-facility group?  Yes No
Group Name(s):

Any extra information you might think we need:
Terms of use
Thank you for partnering with Tri-State Surgical Supply & Equipment.