Credit Card Authorization Form

1. Click on link to access the form. Click Here.
2. Save PDF to your computer.
3. Fill in form. When done, go to step 4.
4. Visit: www.CosMedicalTechnologies.com/GetStarted to get your new product line started!
 
You can also access the order form by clicking on any of the following order form images:
 
Or copy paste this link on your browser: https://cdn.shopify.com/s/files/1/1934/9081/files/Credit_Card_Authorization_Form_-_For_Online_Setups_Only_-_042522v1.pdf?v=1650914983

To view this page, you need to have an account with CosMedical. Please call 800-275-3627 or fill out the Contact Us form to see if you qualify.