✅ Step 1: Complete the Request Form
Use the official form below to request a new order or reorder an existing system. This form is designed to capture all the details needed for our team to follow up with you.
👉 Form Link: Order / Re-Order Request Form
📌 Note: After you submit the form, a representative will contact you within 24 business hours (Monday–Friday) to complete your request.
📝 What You'll Need to Fill Out
Here’s a quick overview of what the form will ask you to provide:
Do You Need to Place an Order?
Select “Yes” to proceed.
Type of Customer
Choose either “Commercial (Business)” or “Personal (Patient).”
Your Contact Information
First Name (Required)
Last Name (Required)
Company Name (Optional for personal use)
Phone Number (Required)
Email Address (Required)
Shipping Zip Code (Required)
System(s) You Want to Order
Select the product(s) you need, such as:
ECO II Replacement Canister (51004)
ECO II Amalgam Separator (51002)
Amalgam Recycling Bucket System
PureWay Sharps Mail-Back Systems
Collection Bins (5, 8, or 18 Gallon)
RX Waste Disposal System
Or choose "Other" to describe your need
🔄 Reordering Tip
If you are reordering a product you've previously purchased, you can reference that item in the "Other" field or select it from the available list. If you're unsure of your past order details, submit the form with as much information as you can — our team will look it up and confirm.
📧 Need Help?
If you have any questions or need help completing the form:
📞 Call: 877-765-3030
📧 Email: support@pureway.com
🕐 Business Hours: Monday–Friday, 9 AM – 5 PM CST
Let us handle the order for you — just fill out the form, and we’ll take care of the rest. Thank you for choosing PureWay Compliance!