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RealTouch™ Global Partnership

    First Name *

    Last Name *

    Email Address *

    Phone Number

    Company Name *

    Company Website *

    Country *

    Email Address *


    Which year was the company founded? *

    To whom are you selling to? (✔ where applicable) *

    How many sales representatives does the company have? (✔ where applicable) *

    How focused is the company in the dental industry? (✔ where applicable) *

    What is the percentage revenue on disposable items e.g. glove, face mask, dam, plastic and non-woven? (✔ where applicable) *

    Please list the top 5 product brands currently represented by your company *

    Are you currently selling gloves? (✔ where applicable) *

    If yes, which brand(s)?

    if yes, who are your major competitors?

    if yes, what is the estimated monthly volume? (box of 100 pieces) (✔ where applicable)

    What is the company's estimated annual sales figure? (in US dollars) *

    Is your company engaged in CSR Program? (✔ where applicable) *

    If yes, what is the focused area? (✔ where applicable)

    if other, please state

    Additional Comments (Optional)

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