MEDI-REDI
Tubing™
- French Sizes - Request Form
PART ONE - ORDER INFORMATION
Date
Phone
First Name
Last Name
Company / Address
Street
Address State
Zip
Country
Product Application
Request Category
Best Effort
Development
Trial
Production
OQ / PQ
Validation
Purchase Order #
Reference Document(s)
PART TWO - MATERIAL DESCRIPTION
ORDER NUMBER
MATERIAL
QUANTITY
LENGTH
SIZE
TOLERANCE
LEVEL
[ TT or ST ]
POLYMER TYPE
[ # OF PIECES ]
STANDARD 48"
OR
CUSTOM
SELECT -
2F-3W -
2F-5W -
3F-3W -
3F-5W -
4F-3W -
4F-5W -
5F-3W -
5F-5W -
5F-7W -
6F-3W -
6F-5W -
6F-10W -
7F-5W -
7F-10W -
8F-5W -
8F-10W -
9F-5W -
9F-10W -
10F-5W -
10F-10W -
11F-5W -
11F-10W -
12F-5W -
12F-10W -
TT
ST
SELECT
PEBAX 35D
PEBAX 40D
PEBAX 55D
PEBAX 63D
PEBAX 72D
POLYAMIDE 12
48" (122 CM)
CUSTOM
-OR-
inch
cm
SELECT -
2F-3W -
2F-5W -
3F-3W -
3F-5W -
4F-3W -
4F-5W -
5F-3W -
5F-5W -
5F-7W -
6F-3W -
6F-5W -
6F-10W -
7F-5W -
7F-10W -
8F-5W -
8F-10W -
9F-5W -
9F-10W -
10F-5W -
10F-10W -
11F-5W -
11F-10W -
12F-5W -
12F-10W -
TT
ST
SELECT
PEBAX 35D
PEBAX 40D
PEBAX 55D
PEBAX 63D
PEBAX 72D
POLYAMIDE 12
48" (122 CM)
CUSTOM
-OR-
inch
cm
SELECT -
2F-3W -
2F-5W -
3F-3W -
3F-5W -
4F-3W -
4F-5W -
5F-3W -
5F-5W -
5F-7W -
6F-3W -
6F-5W -
6F-10W -
7F-5W -
7F-10W -
8F-5W -
8F-10W -
9F-5W -
9F-10W -
10F-5W -
10F-10W -
11F-5W -
11F-10W -
12F-5W -
12F-10W -
TT
ST
SELECT
PEBAX 35D
PEBAX 40D
PEBAX 55D
PEBAX 63D
PEBAX 72D
POLYAMIDE 12
48" (122 CM)
CUSTOM
-OR-
inch
cm
SELECT -
2F-3W -
2F-5W -
3F-3W -
3F-5W -
4F-3W -
4F-5W -
5F-3W -
5F-5W -
5F-7W -
6F-3W -
6F-5W -
6F-10W -
7F-5W -
7F-10W -
8F-5W -
8F-10W -
9F-5W -
9F-10W -
10F-5W -
10F-10W -
11F-5W -
11F-10W -
12F-5W -
12F-10W -
TT
ST
SELECT
PEBAX 35D
PEBAX 40D
PEBAX 55D
PEBAX 63D
PEBAX 72D
POLYAMIDE 12
48" (122 CM)
CUSTOM
-OR-
inch
cm
SELECT -
2F-3W -
2F-5W -
3F-3W -
3F-5W -
4F-3W -
4F-5W -
5F-3W -
5F-5W -
5F-7W -
6F-3W -
6F-5W -
6F-10W -
7F-5W -
7F-10W -
8F-5W -
8F-10W -
9F-5W -
9F-10W -
10F-5W -
10F-10W -
11F-5W -
11F-10W -
12F-5W -
12F-10W -
TT
ST
SELECT
PEBAX 35D
PEBAX 40D
PEBAX 55D
PEBAX 63D
PEBAX 72D
POLYAMIDE 12
48" (122 CM)
CUSTOM
-OR-
inch
cm
Comments
You will receive a cost quotation via email within 24-36 hours or less.