997 Horan Drive
Fenton, MO 63026
Phone: (314) 961- 5786
Fax: (314) 961-4535
SAMPLE/LITERATURE
EVALUATIONS REPORT/SCRUB P.O.
POLICY
NEW REPORTING SYSTEM
As of: January 1st, 2010

All sample/Literature requests need to be completed on a:  Sample/Literature/Evaluation Report/Scrub P.O. Product
Request Form by: Faxing it to Gary at (314-961-4535), or e-mail (gstellern@progressivemedinc.com). Gary will not
process orders via: voice mail unless you have an emergency situation.

Sample/Literature requests will ship on Tuesdays of each week with the weekly mail. So, plan ahead.
ALL REQUESTS FORMS SHOULD BE SUBMITTED TO GARY BY MONDAY -- 5:00pm FOR SHIPMENTS ON
TUESDAY.

Manager approval is required for any urgent or emergency requests (air services). Sales representatives should submit these
special requests directly to your Regional Manager with a copy going to Gary. Once approved, the Regional Manager will
contact Gary for the samples to be shipped to you.

Manager approval is required to ship product directly to account. We expect the rep to be on hand to demonstrate and to
answer questions. Sales representatives should submit these special requests directly to your Regional Manager with a copy
going to Gary. Once approved, the Regional Manager will contact Gary for the samples to be shipped to the account.
HOW TO COMPLETE FORM:
Section One (1):
1. Rep Samples for Facilities:
a) All lines need to be completed for A SPECIFIC FACILITY (One account per request)
b) For large quantities – need explanation in comments section
c) Sample requests for the following vendors MUST include the following information; Facility name,
Surgeon’s name and Surgery date. Samples WILL NOT ship without this information.
*Anchor TRS (All Anchor Bags)
*Genicon
*Medtronics
* Pare Surgical
* PFM Medical
*Quest Medical
2. Rep Samples only:
a) Just need your rep # and name
b) For large quantities – need explanation in comments section
3. Evaluation Report & Scrub Purchase Order:
a) All lines need to be completed for A SPECIFIC FACILITY(One account per request)
Section Two (2):
1. Rep Samples – no need to fill in
2. Evaluation Report & Scrub Purchase Order - NEED ALL LINES COMPLETED
Section Three (3): SAMPLE/LITERATURE REQUEST ONLY
1. See Comments above in Section One & Two  Note: 1 & 2 (Rep Samples or Facility Samples)
2. All lines need to be completed. Be SPECIFIC w/ mfr. that have multiple pieces of literature
3. Item Number & Description MUST be filled in
4. All request quantities need to be in EACHES
5. Comment Section: Need to be specific why you’re requesting LARGE QUANTITY IN EACHES
Section Four (4): EVALUATION REPORT
The following WAREHOUSE vendors require an evaluation report. Direct vendors have their own reports.
 Anchor TRS (All bags), TRS175SB2, TRS180 & TRS200 require reps
to also get a PO
 Genicon
 Gimmi
 Medtronics
 Pare Surgical
 PFM Medical
 PMI Electrodes
 Quest Medical
 Ranfac
 Skinstitch Corp.
1. See Comments above in Section One & Two  Note: 3(Evaluation & Scrub Purchase Order)
2. All lines need to be completed
3. List ONLY ONE manufacturer per report
4. Lot #’s MUST be filled in
5. All quantities need to be in EACHES
6. Comment Section: Need to be specific with surgeon’s comments: I.E: YES, doctor will be your champion on
pushing this product through the committee or hospital or NO, additional evaluations needed, before account closes
or account does not like device – reason WHY
Section Five (5): SCRUB PURCHASE ORDER
1. See Comments above in Section One & Two  Note: 3(Evaluation & Scrub Purchase Order)
2. All lines need to be completed
3. List ONLY ONE manufacturer per report ( Multiple PMI products may be listed)
4. Lot #’s, Qty., Pricing MUST be filled in
5. All quantities need to be in EACHES
6. Send Copy of Scrub Purchase Order to PMI CUSTOMER SERVICE
What Specific Manufacturers apply to this form for the following requests:
 Sample/Literature: ALL VENDORS need a Sample/Literature Request submitted to PMI office (Gary Stellern)
 Scrub Purchase Order: Attn: PMI Customer Service

See PMI Library on the Web Page for the manufacturer specific forms
REUSABLE EQUIPMENT:
 Should include the information above. Equipment must be returned within three (3) weeks, unless otherwise noted on the
request. Reps will be held responsible for any equipment not returned.
SPECIFIC REQUESTS TO MFR.:
 GIMMI (Tri-Delta) instruments ……..all information request need to be communicated DIRECTLY with Wayne Short.
Sample requests are subject to their availability/policy.
Contact Info
Office Line
Cell Phone #
E-Mail
Wayne Shortt
800.231.1364
801.550.3740
wayneshortt@servicdevices.com
Reps should not call manufacturers for samples or literature.
Following these procedures will help to facilitate the sampling process and it will help to insure that you receive the samples you
requested. Many times our manufacturers ask us where their samples are being used. The Hospital information you write in on
your request form gives us the answer for our manufacturers.
GLOSSARY OF TERMS:
Evaluation: Facility agrees to use a PMI product for a scheduled evaluation with a surgeon.
NO Charge Scrub P.O.: Facility policy does not allow them to pay for an evaluation. If this occurs, facility will only
be allowed one evaluation. The second procedure the account needs to pay for evaluation.
Payable Scrub P.O.: Facility agrees to pay for the evaluation – Purchase Order to be sent to PMI for billing and invoiced.