Please complete the brief form below to redeem your free box of Little Sucker or NeoSucker. Supplies are limited.

Offer is non-transferable and valid for select U.S.-based customers with accounts in good standing. Requests per hospital, company or department are fulfilled at the discretion of Neotech Products.

First Name *

Last Name *

Email *

Phone Number

Medical Facility/Company Name *

Department *

Number of Beds

Does your facility have a new trial policy? * YesNoI'm not sure

What do you currently use for suction? *

Select your free box of 50 * N204 Preemie N205 Standard N206 Preemie Curved N207 Standard Curved N208 XL Curved N225 Standard Nasal N224 Preemie Nasal

Ship to Address *

Apartment, suite, unit, etc. (optional)

City *

State *

Zip *

Order Notes (optional)

Comments