Contact

317 E.Foothill Blvd.Suite 205.
Arcadia, CA 91006

+1 (626)-671-5278

[email protected]

New Customer Registration

Help us understand your needs better

Welcome!

Below are 8 questions that we hope you will take the time to answer. Your cooperation in providing this information is crucial for us to gain a better understanding of you and your company. This will enable us to offer more effective support in the future. Answering these questions won't take much of your time, but it is extremely important for us.

1. What best describes your company's primary activity? (Please select one. If "Other," please specify.)

Endoscope Repair Service Provider

(Your company repairs flexible/rigid endoscopes for hospitals or other clients.)

R&D / Special Projects

(Developing your own endoscopes, custom devices, robotics, or special prototypes.)

Refurbish & Resell Used Endoscopes

(Purchasing pre-owned scopes, refurbishing them, and reselling to end users.)

Medical Professional / Doctor Repairing Own Equipment

(Individual doctor or clinic performing limited in-house repairs.)

Other:

2. What types of endoscopes do you primarily repair? (Please fill in each category that applies. If you don't repair the category, please put "NO")

A. Large-Diameter

Most common models you repair:

Average monthly Qty for large-diameter models (in total):

B. Small-Diameter

Most common models you repair:

Average monthly Qty for small-diameter models (in total):

C. Semi-Rigid

Most common models you repair:

Average monthly Qty for semi-rigid models (in total):

D. Other Types or Brands

Please specify the type or brand:

Most common models:

Average monthly repair volume:

E. If you do NOT perform any repairs

(For companies or individuals engaged in other activities)

(you may leave questions A, B, C, D above blank)

3. Which brands do you primarily work with? (Please select all that apply. If you do not perform any repairs, please select "Other" and provide a brief explanation.)

Olympus

Pentax

Fujinon

Storz

Other

4. What is your position in the company? (Multiple selections allowed. If "Other," please specify.)

Owner / Founder

Operations Manager

Lab Manager

Technician / Engineer

Purchasing

Sales

Doctor / Medical Staff

R&D Specialist

Other

5. How many technicians does your company have?

6. How many years of work experience do you have (as a purchaser or as a technical professional) in this industry?

7. How did you hear about us?

Online Search

Through (Google, YouTube, or other search engines):

Referral from a Friend / Colleague

Referred by:

Industry Event / Trade Show

Other:

8. What is the biggest challenge you are currently facing with your endoscope parts or repair supply? (Please select all that apply. This information helps us better understand your situation so we can provide the most suitable products and support.)

Quality issues with your current vendor

Frequent stock shortages or inconsistent availability

Long lead times / slow delivery

Pricing concerns

Difficulty sourcing certain models or specific parts

Lack of reliable specialty or R&D components

Poor communication or support from current suppliers

Other

Please describe your situation in more detail, or any suggestions you have, in order to gain your business. (optional):

Contact Information

Company Name:

Primary Contact

First Name & Last Name:

Title / Position:

Office Phone Number:

Mobile Phone Number:

Email Address:

Preferred Contact Method (select one or more):

Office Phone

Mobile Phone

(optional – if applicable to your business)

Secondary Contact (Optional)

First Name & Last Name:

Title / Position:

Office Phone Number:

Mobile Phone Number:

Email Address:

Preferred Contact Method (select one or more):

Office Phone

Mobile Phone

(optional – if applicable to your business)

Billing Address:

Shipping Address:

Shipping Method

Please select your preferred shipping carrier:

FedEx

UPS

DHL

Do you have your own shipping account with the selected carrier?

Yes, I have a shipping account.

No, I do not have a shipping account.

In this case, the shipping cost will be prepaid by us and added to your invoice. Please still select your preferred carrier above.

Additional Note:

For each order, you may also provide additional shipping instructions, such as:
• Required delivery date or deadline
• Special service type (e.g., Overnight, 2-Day, Ground, Express International)
• Any specific handling notes

If you would like a shipping cost estimate, please let us know when submitting your order. Our team will review the destination and package details and reply with a reference quote.

Payment Method

Please select your preferred payment method. New customers are required to complete payment before shipment, and orders are generally shipped on the same business day the payment is received. You may update your preferred payment method for each individual order.

Payment Options (Please select one):

Credit Card

ACH (U.S. Only)

Bank Wire Transfer

PayPal

Zelle