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Heartland Connect
Idaho Falls
Boise
Denver
Salt Lake City
Resources & News
Switching to Heartland
Services
About Us
Careers
Contact
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Equipment Request Form
Once this ticket has been submitted, a Heartland Pharmacy representative will contact you for solutions, costs and additional information regarding your equipment.
Name
(Required)
Phone
(Required)
Email
(Required)
Community Name
(Required)
Community Address
(Required)
Scanner Issues:
Med Cart Serial Number:
Lock Issues:
Keys:
Narc Box/Drawer
Sharps
Main Cart
Rails:
Additional Equipment Requests:
More Information:
Do you need Med Destruction Liners?
Yes
No
To order out-of-schedule liners, please call Sharps Compliance, Inc. at 800.772.5657 or fill out the information below. By completing this form, you and your community agree to pay the $270/liner plus a processing fee.
Name
Email
Community Name
Community Address
Liner Size
18-Gallon
38-Gallon
For laptop and fax machine questions, trouble shooting, etc. please call Treasure Valley IT at 208-367-1000 or help@tvit.net.
*Please be aware that service fees and charges may apply to this ticket and request.
Fill out the form below to get a quick, reliable answer.
Name
*
Phone
Email
*
Community Name
Community - Vaccine Resident
Community - Vaccine Staff
Pharmacy location
*
Location of servicing pharmacy
Idaho Falls
Boise
Colorado
Utah
Message
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.
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