Code Blue Corporation

Date*
mm/dd/yyyy
MM slash DD slash YYYY
Your Name*
First Last
Your Organization*
Your Email*
Your Phone
End User*
End User Location*
City State / Province / Region
What type of product are you interested in customizing?
- Help Point
- Speakerphone
- Software
- Other
How would you like to customize our product for your project?*
Please includes specifics related to physical design, functionality and/or user experience. Drawings or specifications can be attached below.
How will this custom solution benefit your location?*
Please includes specifics related to physical design, functionality and/or user experience.
How many would you be interested in purchasing?
Immediately In the Next Year In the Next 2-3 Years
Are there any products on the market that are similar to what you are requesting?
Please list any applicable manufacturer and model information.
What sales partners are you working with (Rep firms, Integrators, Distributors, etc.)
Is there any additional information you would like to share?
Upload Supporting Documenation
Drop files here or

Max. file size: 50 MB.
CAPTCHA

Solutions Custom Request Form

Immediately	In the Next Year	In the Next 2-3 Years