ÿþ<html> <head> <title>United Endoscopy - Contact Us</title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <script src="Scripts/AC_RunActiveContent.js" type="text/javascript"></script> <SCRIPT LANGUAGE="JavaScript1.1"> <!-- Begin function right(e) { if (navigator.appName == 'Netscape' && (e.which == 3 || e.which == 2)) return false; else if (navigator.appName == 'Microsoft Internet Explorer' && (event.button == 2 || event.button == 3)) { alert("The Right click option on your mouse has been disabled for the download window pages."); return false; } return true; } document.onmousedown=right; document.onmouseup=right; if (document.layers) window.captureEvents(Event.MOUSEDOWN); if (document.layers) window.captureEvents(Event.MOUSEUP); window.onmousedown=right; window.onmouseup=right; // End --> </script> <script language="JavaScript" type="text/JavaScript"> <!-- function MM_findObj(n, d) { //v4.01 var p,i,x; if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) { d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);} if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n]; for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document); if(!x && d.getElementById) x=d.getElementById(n); return x; } function MM_validateForm() { //v4.0 var i,p,q,nm,test,num,min,max,errors='',args=MM_validateForm.arguments; for (i=0; i<(args.length-2); i+=3) { test=args[i+2]; val=MM_findObj(args[i]); if (val) { nm=val.name; if ((val=val.value)!="") { if (test.indexOf('isEmail')!=-1) { p=val.indexOf('@'); if (p<1 || p==(val.length-1)) errors+='- '+nm+' must contain an e-mail address.\n'; } else if (test!='R') { num = parseFloat(val); if (isNaN(val)) errors+='- '+nm+' must contain a number.\n'; if (test.indexOf('inRange') != -1) { p=test.indexOf(':'); min=test.substring(8,p); max=test.substring(p+1); if (num<min || max<num) errors+='- '+nm+' must contain a number between '+min+' and '+max+'.\n'; } } } else if (test.charAt(0) == 'R') errors += '- '+nm+' is required.\n'; } } if (errors) alert('The following error(s) occurred:\n'+errors); document.MM_returnValue = (errors == ''); } //--> </script> <STYLE TYPE="text/css"> <!-- P {text-indent: 12pt;} --> </STYLE> </head> <body> <table> <tr> <td align='right'> <OBJECT height=154 alt="Visit Seller's Store" width=350 align=left><PARAM NAME="movie" VALUE="http://office.endoscope.com/Flash_/logo_shine.swf "><PARAM NAME="quality" VALUE="high"> <EMBED src=http://office.endoscope.com/Flash_/logo_shine.swf quality=high WIDTH="350" HEIGHT="154" NAME="MyMovieName" ALIGN="left" TYPE="application/x-shockwave-flash" PLUGINSPAGE="http://www.macromedia.com/go/getflashplayer"></EMBED> </OBJECT> </td> <td align='left'> <h3><P CLASS="indented"> We are here to assist you Monday-Friday 8am-5pm Pacific Standard Time.</P><hr> <p><em>Our priority is to serve your practice with top quality medical equipment. We look forward to doing business with you, and being a part of your success.</em></P> </p> </h3> </td> </tr> <!-- // EDIT // --> <a name="Contact Us"></a> <table width="720" cellpadding="0" cellspacing="0" border="0" align="center"> <tr height="56"> <td width="28"><img src="http://office.endoscope.com/box_image/02_box_tl.gif"></td> <td background="http://office.endoscope.com/box_image/02_box_tp.gif" valign="bottom"><font class="heading1"><b>Contact Us</b></font></td> <td width="28"><img src="http://office.endoscope.com/box_image/02_box_tr.gif"></td> </tr> <tr> <td width="28" background="http://office.endoscope.com/box_image/02_box_lt.gif"><img src="http://office.endoscope.com/box_image/spacer.gif" width="28"></td> <td class="reg"> <p align="center" class="textbig"><u class="texttop"> <br> Due to the large interest in our products, we will respond to serious requests only.</u></p> <form name="form" method="post" action="http://form.medave.com/aspformmail.asp"> <input type=hidden name="recipient" value="ron@unitedendoscopy.com"> <input type=hidden name="redirect" value="http://office.endoscope.com/screens/email_sent.asp"> <input type=hidden name="subject" value="Ron Beekman - Info Request from eBay"> <span class="texttopblack"><span class="style1">*</span> Required Field </span> <div align="left"> <table width="500" border="0" align="center" class="text"> <!--DWLayoutTable--> <tr> <td width="108" height="22"><font face="Arial"><small><span class="style1">*</span></small></font><font face="Arial" color="#5776E9"><small> First Name<br> </small></font></td> <td width="387" align="left" valign="top"> <input NAME="First Name" TYPE="text" id="First Name" tabindex="1" VALUE SIZE="20"> </td> </tr> <tr> <td align="right"><div align="left"><font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>Last Name</small></font> </div></td> <td align="left"><input name="Last Name" type="text" id="Last Name" tabindex="2" value size="20"></td> </tr> <tr> <td align="right"><div align="left"><font face="Arial" color="#5776E9"><small>Organization</small></font></div></td> <td align="left"><input NAME="Organization" TYPE="text" id="Organization" tabindex="3" VALUE SIZE="30"></td> </tr> <tr> <td align="right"><div align="left"><font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>Address Line 1</small></font></div></td> <td align="left"><input NAME="Address" TYPE="text" id="Address" tabindex="4" VALUE SIZE="30"></td> </tr> <tr> <td align="right"><div align="left"><font face="Arial" color="#5776E9"><small>Address Line 2</small></font></div></td> <td align="left"><input NAME="Address2" TYPE="text" id="Address2" tabindex="5" VALUE SIZE="30"></td> </tr> <tr> <td align="right"><div align="left"><font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>City</small></font></div></td> <td align="left"><input NAME="City" TYPE="text" id="City" tabindex="6" VALUE SIZE="30"> <font face="Arial" color="#5776E9"><small>State</small></font> <input NAME="State" TYPE="text" id="State" tabindex="7" VALUE SIZE="4"></td> </tr> <tr> <td align="right"><div align="left"><font face="Arial" color="#5776E9"><small>Postal Code</small></font></div></td> <td align="left"><input NAME="Zip Code" TYPE="text" id="Zip Code" tabindex="8" VALUE SIZE="15"> <small><font face="Arial"><span class="style1">*</span> </font><font face="Arial" color="#5776E9">Country</font></small> <input NAME="Country" TYPE="text" id="Country" tabindex="9" VALUE SIZE="15"></td> </tr> </table> </div> <div align="left"> <table width="505" border="0" align="center" class="text"> <!--DWLayoutTable--> <tr> <td align="right" width="50"><div align="left"><font face="Arial" color="#5776E9"><small>Country Code</small></font></div></td> <td align="left" width="388"><input NAME="Phone Country Code" TYPE="text" id="Phone Country Code" tabindex="10" VALUE SIZE="5"> <font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>Area Code</small></font> <input name="Area Code" type="text" id="Area Code" tabindex="11" value size="5"> <font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>Phone </small></font> </td> <td> <input NAME="Phone Number" TYPE="text" id="Phone&nbsp Number" tabindex="12" VALUE SIZE="20"></td> </tr> </table> </div> <div align="left"> <table width="505" border="0" align="center" class="text"> <!--DWLayoutTable--> <tr> <td width="99" height="24"><font face="Arial"><small><span class="style1">* </span></small></font><font face="Arial" color="#5776E9"><small>E-Mail Address</small></font></td> <td width="396" align="left" valign="top"><font face="Arial" color="#5776E9">&nbsp;</font> <input NAME="Email" TYPE="text" id="Email" tabindex="16" VALUE SIZE="30"></td> </tr> </table> </div> <table width="520" border="0" align="center" bordercolordark="#FF0000" class="text"> <tr> <td width="100%" colspan="2" align="center" bgcolor="#EFEFFF"><strong>PICK ONE OR MORE</strong></td> </tr> <tr> <td width="100%"><strong><font color="#5776E9">Type of Instrument System</font>:</strong><br> <select name="type_of_instrument_syst" size="4" multiple tabindex="17"> <option value="Fiber Scope">Fiber Scope</option> <option value="Video Scope">Video Scope</option> <option value="Complete Video System">Complete Video System</option> <option value="Complete Laparoscope System">Complete Laparoscope System</option> <option value="Complete Arthroscope System">Complete Arthroscope System</option> <option value="Complete Cystoscope System">Complete Cystoscope System</option> <option value="Complete Hysteroscopy System">Complete Hysteroscopy System</option> <option value="Other">Other</option> </select></td> <td width="50%"><font color="#5776E9"><strong>Manufacturer:</strong><br> <select name="manufacturer" size="4" multiple tabindex="18"> <option value="Acufex">Acufex</option> <option value="Baxter">Baxter</option> <option value="Concept">Concept</option> <option value="Dyonics">Dyonics</option> <option value="Eder">Eder</option> <option value="Fujinon">Fujinon</option> <option value="Olympus">Olympus</option> <option value="Storz">Storz</option> <option value="Stryker">Stryker</option> <option value="Linvatec">Linvatec</option> <option value="Circom/ACMI">Circom/ACMI</option> <option value="Pentax">Pentax</option> <option value="Welch Allen">Welch Allen</option> <option value="Wolf">Wolf</option> <option value="Solos">Solos</option> <option value="Sony">Sony</option> <option value="Toshiba">Toshiba</option> <option value="Panosonic">Panosonic</option> <option value="U.S. Surgical">U.S. Surgical</option> <option value="Machida">Machida</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr> <td width="100%"><font color="#5776E9"><strong>Flexiblescopes</strong>:<br> <select name="flexiblescopes" size="4" multiple tabindex="19"> <option value="Bronchoscope">Bronchoscope</option> <option value="Gastroscope">Gastroscope</option> <option value="Colonoscope">Colonoscope</option> <option value="Doudeonoscope">Doudeonoscope</option> <option value="Sigmoidoscope">Sigmoidoscope</option> <option value="Nasopharyngolaryngoscope">Nasopharyngolaryngoscope</option> <option value="Ueteroscope">Ueteroscope</option> <option value="Cystoscope">Cystoscope</option> <option value="Hystereoscope">Hystereoscope</option> <option value="Angioscope">Angioscope</option> <option value="Choledochoscope">Choledochoscope</option> <option value="Other">Other</option> </select> </font></td> <td width="50%"><font color="#5776E9"><strong>Rigid Scopes:</strong><br> <select name="rigid_scopes" size="4" multiple tabindex="20"> <option value="Arthroscopes">Arthroscopes</option> <option value="Cystoscope">Cystoscope</option> <option value="Laparoscope">Laparoscope</option> <option value="Ueteroscope">Ueteroscope</option> <option value="Carpet Tunnel Scope">Carpet Tunnel Scope</option> <option value="ENT Scope">ENT Scope</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr> <td width="100%"><font color="#5776E9"><strong>Instruments</strong>:<br> <select name="instruments" size="4" multiple tabindex="21"> <option value="Arthroscopic">Arthroscopic</option> <option value="Laparoscopic">Laparoscopic</option> <option value="Cystoscopy/ueteroscopy">Cystoscopy/ueteroscopy</option> <option value="ENT">ENT</option> <option value="G.I. Endoscopy">G.I. Endoscopy</option> <option value="Hysteroscopy">Hysteroscopy</option> <option value="Other">Other</option> </select> </font></td> <td width="50%"><font color="#5776E9"><strong>Individual Accessories:</strong><br> <select name="accessories" size="4" multiple tabindex="22"> <option value="Camera System">Camera System</option> <option value="Light Source">Light Source</option> <option value="Shaver (arthroscopic)">Shaver (arthroscopic)</option> <option value="Insufflator">Insufflator</option> <option value="Cart">Cart</option> <option value="Power Equipment">Power Equipment</option> <option value="Hand Instruments">Hand Instruments</option> <option value="Other">Other</option> </select> </font></td> </tr> <tr> <td width="100%"><strong><span class="style1">*</span></strong><font color="#5776E9"><strong>I am a:</strong><br> </font> <select name="i_am_a_req" size="4" tabindex="23"> <option value="Physician/Surgeon">Physician/Surgeon</option> <option value="Hospital/Surgery Center">Hospital/Surgery Center</option> <option value="Veterinarian">Veterinarian</option> <option value="Dealer/Distributor">Dealer/Distributor</option> <option value="Purchasing Agent">Purchasing Agent</option> <option value="Industrial/non-medical">Industrial/non-medical</option> </select></td> </tr> <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr> <tr> <td colspan="2"><small><strong><font color="#5776E9" size="2"><strong>Comments:</strong></font></strong></small><br> <textarea name="comment" rows="5" cols="70" tabindex="24"></textarea> </td> </tr> <tr> <td colspan="2"><small><font color="#5776E9" size="2"><strong>First Language:</strong></font></small><font face="Arial" color="#800080"><small><b> </b> <select name="lang" size="1"> <option value="be.Japanese"> åe,gžŠ </option> <option value="be.dutch"> Nederlands </option> <option value="br.portuguese"> Português </option> <option value="co.spanish"> Español </option> <option value="de.german"> Deutsch </option> <option value="it.italian"> Italiano </option> <option selected value="us.english">US English</option> </select> </td> </tr> <tr> <td colspan="2"><small><font color="#5776E9" size="2"><strong>Second Language:</strong></font></small><font face="Arial" color="#800080"><small><b> </b> <select name="lang" size="1"> <option value="be.Japanese"> åe,gžŠ </option> <option value="be.dutch"> Nederlands </option> <option value="br.portuguese"> Português </option> <option value="co.spanish"> Español </option> <option value="de.german"> Deutsch </option> <option value="it.italian"> Italiano </option> <option selected value="us.english">US English</option> <option value="Other">Other</option> </select>&nbsp&nbsp&nbsp <input name="submit" type="submit" onClick="MM_validateForm('First Name','','R','Last Name','','R','Address','','R','City','','R','Country','','R','Area Code','','RisNum','Phone Number','','RisNum','Email','','RisEmail');return document.MM_returnValue"> &nbsp&nbsp&nbsp&nbsp <input name="reset" type="reset"> </small></font></td> </tr> </table> </td> <td width="28" background="http://office.endoscope.com/box_image/02_box_rt.gif"><img src="http://office.endoscope.com/box_image/spacer.gif" width="28"></td> </tr> <tr height="28"> <td width="28"><img src="http://office.endoscope.com/box_image/02_box_bl.gif"></td> <td background="http://office.endoscope.com/box_image/02_box_bm.gif" valign="bottom">&nbsp;</td> <td width="28"><img src="http://office.endoscope.com/box_image/02_box_br.gif"></td> </tr> </table> </tr> </table> <!-- Start of StatCounter Code --> <script type="text/javascript" language="javascript"> var sc_project=2118153; var sc_invisible=1; var sc_partition=19; var sc_security="ccb59103"; var sc_remove_link=1; </script> <script type="text/javascript" language="javascript" src="http://www.statcounter.com/counter/frames.js"></script><noscript><img src="http://c20.statcounter.com/counter.php?sc_project=2118153&amp;java=0&amp;security=ccb59103&amp;invisible=1" alt="cool hit counter" border="0"> </noscript> <!-- End of StatCounter Code --> </body> </html>