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Quantum Rehab 401 York Ave., Dryer, PA 18642 Phone: 8668002002 Fax: 8667073422 Email: quantum orders pride mobility.comJ4 Order Form with Power Positioning Seating Account Number: Date: Provider Name:

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To fill out the J4 order form, follow these steps:

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Start with the personal information section: Enter your name, address, contact number, and email address.

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Move on to the product details section: Specify the quantity of each product you want to order, along with any variations or options.

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The J4 order form is needed by individuals or businesses who want to place an order for J4 products. This form is used to provide necessary details for processing the order and arranging the delivery. It can be used by retail customers, wholesale buyers, or anyone interested in purchasing J4 products.

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