Discount/Bulk Order Form .

In order for us to better serve you and provide the most competitive pricing, please complete as much of our
Bulk Order Inquiry Form as possible. We understand there may be some questions you are unable to complete
and that some of the information may change throughout the process.

If you have any questions , please call Marketing Department at 1.800.848.6443
or BulkOrders@IdentifyYourself.com.

Please note: The most competitive pricing is available for bulk orders, defined as a minimum of 25 units of the
same product with same/similar engraving shipping to a single location. We are, however, able to process and price custom engraved orders.

Order Form



Organization Name:

Organization Address:

Contact First Name:

Contact Last Name:

Contact Phone:

Contact Email:

What Medical ID bracelet, necklace or USB are you interested in for your special order?
Please reference the product name as it appears on our website at www.IdentifyYourself.com.

Please include the metal type, product name, and whether you have selected a necklace, bracelet, key chain, or USB.

Do you need a specific chain or clasp style? YES NO
(if "NO", simply leave blank and we will recommend the best priced item)

Chain style desired: Clasp style desired:

Quantity Needed:

Will your medical IDs be identically sized? YES NO
If NO, please indicate quantities needed in each size:

Will your medical IDs be identically engraved? YES NO NO ENGRAVING NEEDED
If yes, what would you like engraved? (If possible, please locate the ID you’ve selected online and refer to the available line/character limitations.)

What date do you need the medical IDs delivered?
Average processing time is 4 to 6 weeks from payment.

Do you require processing sooner than 4 to 6 weeks? YES NO
Rush fee will apply and will be quoted separately. Please note Rush options may not apply to all orders due to product availability.

Will you use your own shipping account (UPS or FedEx) or do you need to use ours?
Shipping using American Medical ID / Universal Medical ID account will be quoted separately.

Will all medical IDs be shipped to a central location? YES NO
Please note shipping address(es) here, or simply indicate “same” if same as address listed above.

Will this be a recurring order or one time purchase? Please check one option.
Recurring Order One Time Purchase
If this is a recurring order, how often will you need your requested order fulfilled?
Weekly Monthly Quarterly Annually One Time Purchase Other

Are there any other things you would like us to consider in preparing your quote?

Additional Notes:
- Any additional and/or special handling may affect price of quote.
- Payment in full is required before any processing is started.
- Quotes will be honored for 30 days from date of issue.
- We reserve the right to change pricing at any time after initial 30 day period, including for recurring orders.

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