1. Company and Service

2. Cycle and Wearers

3. Review and Confirm

			Business Location
	Victor Medical Customer No
	Company
	Attn
	Street
	City
	State		Alaska Alabama Arkansas Arizona California Colorado Connecticut District Of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
	Zip
			Main Contact Information
	Name
	Email
	Phone
	Password
	Password		Enter again to confirm

		TLD-XBGN   (Standard Badge) Recommended for monitoring exposure to x-ray, beta and gamma radiation.
		TLD-XBGN Ring Recommended for monitoring exposure to x-ray, beta and gamma radiation.
		TLD-XBGN+   (for Neutrons) Recommended for monitoring exposure to x-ray, beta, gamma and/or neutron radiation in the presence of complex mixed radioactive sources.