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North America: +1 (866) 862-9682

Phone: +1 (519) 438-2409

Contact Support

Email: support@modusQA.com 

Phone: +1 (519) 438-2409 Option 3

Modus Medical Devices Inc.

1570 North Routledge Park

London, ON N6H 5L6 

Canada

Become a Distributor

Thank you for your interest in distributing Modus QA products. Please fill out the application request form below to connect directly with our International Business Development Manager.

Your information will be kept confidential and will allow us to take the first step towards understanding how we might work together.  Modus QA reserves the right to reject any application without comment.

General Information

Billing Address

Shipping Address

Contacts

Products

What product categories are you interested in selling?

Caution to Signatory

As the person submitting this application request form, you represent and warrant that you have the authority to provide the information required and to submit this form. If you do not have the appropriate authority and/or cannot provide the required information, please exit now.  If you have the appropriate authority and can provide the required information, please click on the check box below and click on the “Submit” button. 

Your privacy is important at Modus QA. To review how Modus Medical Devices Inc. safeguards your personal information, please see the Modus QA Privacy Policy.

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