Your Name (required):
Your Email (required):
Your Telephone Number (required)
Your Clinic Name (required)
Your Ocean Site Number (Please enter 0 if no site number available)
Please select your " preferred Ocean Kiosk modelFloor Stand Kiosk ($550 + Shipping)Wall-Mount Kiosk ($310 + Shipping)Countertop Kiosk ($310 + Shipping)
How many Ocean Kiosk stands are you ordering
Please confirm the Android Tablet model you are using to ensure appropriate Kiosk size Samsung Galaxy E 9.6"Samsung Galaxy A 10.1"
*FOR CLINICS IN ONTARIO, NOVA SCOTIA, AND BRITISH COLUMBIA ONLY. Would you like to purchase a hardware peripheral bundle from CognisantMD or will you order the peripherals directly? Please note that peripheral bundles include one formatted Magtek reader, one power adapter and an extension cord (Android tablet is NOT included). Please send me a peripheral bundle for each kiosk stand (You will be invoiced $250 per bundle)I will order my own peripheralsNot applicable
Please provide your shipping contact name and address
*Please note that Kiosk stands do not ship until payment is received.
*Please note that Kiosk stands may only be returned or exchanged within 30 days of purchased, undamaged and in the original box. Kiosk returns are subject to a restocking fee of $150.00.