Order Request

We cannot process card payments online at present, we're working on it. In the meantime, if you are not an account customer and wish to place an order or can't find something you're looking for, please complete the form below. 

What happens next?

We will contact you and/or email to confirm the details of your order and arrange payment. 

Your Name: *
Contact Telephone No.: *
Contact Email Address:
Company Name (if applicable):
Product Codes & Quantity to Order: *
Delivery Address: *
Post Code: *
Our Privacy Notice and how we process personal data, can be found at b2b.mediq.co.uk
Our Privacy Notice and how we process personal data, can be found at b2b.mediq.co.uk