Inquiry

Sample Request Form

If you have any comments or requests for our company, please feel free to contact us.

If the quantity of samples requested is large, a separate estimate may be required. Please consult with us.

We will reply you about your inquiries during our business hours.
Business hours: 8:15 a.m. to 5:00 p.m. Japan time (excluding Saturdays, Sundays, holidays, and summer and New Year holidays)

＜ For sending samples outside Japan.＞
Area covered by EMS: We will ship by EMS. (Shipping costs are borne by us)
If you are not in an area covered by EMS: Please arrange for transportation. (Pay on delivery. You are responsible for shipping costs.

Please input the following items, and push the "Confirmation of input contents" button.

Samples you want 1 : Syringe	unnecessary X120PL183K（0.5ml, Transparent） X113P481K（1.0ml, White） X114P681K（1.0ml, Pink） X115P581K（1.0ml, Purple） X130P19（Cap, White） X130P29（Cap, Black） ※Each item will be sent one at a time. If you would like more than one, please write the number you would like in the remarks column.
Samples you want 2 : Tips	unnecessary X020P1910K（Tip21G Straight） X022P1910K（Tip21G Long Straight） X021P1910K（Tip21G Bent） X060P1910K（Tip21G Bent75） X023P1910K（Tip21G Long Bent） X050P1910K（Tip22G Curve） X030P1910K（Tip25G Straight） X032P1910K（Tip25G Long Straight） X031P1910K（Tip25G Bent） X033P1910K（Tip25G Long Bent） X040P1910K（Tip27G Straight） X041P1910K（Tip27G Bent） X035P1810K（Tip25G Sideholes Bent/IRRI-Tip 25G Double Side Vent） X043P1810K（Tip27G Sideholes Bent/IRRI-Tip 27G Double Side Vent） X091P1710K（Tip30G Sideholes Bent/IRRI-Tip 30G Double Side Vent） ※Each item will be sent one at a time. If you would like more than one, please write the number you would like in the remarks column.
remarks
Company
Section
Name
E-Mail
TEL	- -
Facsimile number	- -
Address

After confirming the above contents, please click the "To confirm input contents" button below if you like.