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How to Order Without Using the Online Store

Updated yesterday

Placing or reordering a PureWay system doesn’t have to be complicated. While our online store is always an option, you can also submit a request directly using our official form. This step-by-step process ensures our team has all the information needed to handle your order quickly and accurately.

Note:

  • 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.

  • After you submit the form, a representative will contact you within 24 business hours (Monday–Friday) to complete your request.


What You will Need to Fill Out

To make your order quick and easy, the form asks for some basic details about you, your clinic, and the products you need. Filling it out fully helps our team confirm your request and get your items to you without delay.

Here’s a quick overview of what the form will ask you to provide:

  1. Do You Need to Place an Order?

    • Select “Yes” to proceed.

  2. Type of Customer

    • Choose either “Commercial (Business)” or “Personal (Patient).”

  3. 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)

  4. 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

Note:

  • 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

  • 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!

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