Order and Quotation Form

”BIS-ORTA” Vascular Model System with Sensors Order and Quotation Form

Quotation Process

  • STEP 1

    Select "Order Request" in the "Details of Request" section of the form and fill in the required information.

  • STEP 2

    After submitting the form, you will receive a confirmation email.

  • STEP 3

    We will send you a quotation to the e-mail address you entered in the form within a week.

Ordering Process

  • STEP 1

    Select "Order Request" in the "Details of Request" section of the form and fill in the required information.

  • STEP 2

    After submitting the form, you will receive a confirmation email.

  • STEP 3

    We will send you a quotation and invoice to the e-mail address you entered in the form within one week.

  • STEP 4

    Please check the contents of the quotation, and if you are satisfied with the quotation, please make a bank transfer to the bank account indicated on the invoice.

  • STEP 5

    We will arrange for the manufacturing of the product and inform you of the delivery date.

  • STEP 6

    After receiving the product, please inspect the product and check its operation.

Fill out your order/quote

Please fill out the following form and select the "Confirm" button.
All fields are required except for a few.

Details of your request

”BIS-ORTA” Vascular Model System with Sensors

Name of Hospital or Facility /Department

Name of person in charge

E-mail address

Re-enter for confirmation

Phone number (*no hyphen)

Postal code (*no hyphen)

Your Address

State/Province
City/Town/Village
Address below
Building name etc.

Use of Personal Information for ORDER of Sensor-equipped vascular model system, BIS-ORTA

Blue Practice collects and uses personal information from the person in charge of requesting the Sensor-Equipped Vascular Model System BIS-ORTA. This information is used for processing orders and quotation, issuing invoices, and shipping products in cases where we are commissioned.


Collected Personal Information

The following personal information is required for ordering and requesting quotations:
• Request Information: Order request, quotation request
• Customer Information: Company/hospital name, department, name, furigana, email address, phone number, postal code, prefecture, city/ward, street address, building name, etc.


Purpose of Use of Personal Information

The personal information of the request representative will be used for the following purposes:
• To confirm order details (via phone, email)
• To send quotation and invoices (via phone, email, or mail)
• To communicate regarding manufacturing (via phone, email)
• To ship products and delivery slips
• For representative/sales management and billing processing
• For after-sales support
• To provide information on services
• To improve products and services


Outsourcing of Personal Information Handling

This website uses data centers for hosting the form, and Japan Post and Yamato Transport for shipping products. Part of the manufacturing process may be outsourced.


Provision of Personal Information to Third Parties

Personal information provided in connection with orders, quotations, and commissioned manufacturing will not be shared with third parties.


Disclosure, Correction, and Suspension of Use of Personal Information

To confirm, correct, or suspend the use of registered information after submitting an order or quotation, please contact your sales representative or the Personal Information Inquiry Desk.


Complaints and Consultations Regarding Personal Information

For complaints or consultations regarding the handling of personal information related to orders, quotations, or manufacturing, please contact the Personal Information Inquiry Desk using the contact form.


Blue Practice Inc.
Plaseo Aoyama Building 3F, 2-7-13 Kita-Aoyama, Minato-ku, Tokyo
Personal Information Protection Officer
Contact Form

  • Blue Practice

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