Torpac Information Request Form

A real live human being who knows about capsules and capsule equipment replies to all requests within 1-2 days.
Please take care and time in answering the questions below so we can help you to the best of our ability!
Please do not use this form to place orders or enquire about orders you have placed. Contact your Torpac representative via email.

Contact Information


Name
Title
Organization
Country
Work Phone
E-mail
Contact Via		phone fax email


Street Address
Address (cont.)
City
State/Province
Zip/Postal code
FAX
Website

I am interested in the following:

Capsules

Veterinary Size Capsules
Size 000-5 Human Size Capsules
Rat Capsules (Size 9, 9el, 9h, M)
Special Size / Custom Capsules
Toy Capsules
Special Effects

Veterinary Capsule Fillers

ProFill Vet (handheld)
Vet Clinic Filler (handheld)
Veterinary Capsule Filler 2G (benchtop)

Capsule Fillers

ProFiller 1100 (handheld)
ProFiller 1120 (handheld)
ProFiller 1060 (handheld) [EU ONLY]
ProFiller 3600 (handheld)
ProFiller X900 (benchtop)
ProFiller 3700 (benchtop)
ProFiller 3800 (benchtop)
ProFiller 3700OE (benchtop)

Capsule Fillers Discontinued (limited availablity)

ProFill 100 (handheld)
ProFill 3006 (handheld)
ProFill 3007 (benchtop)
ProFill 3008 (benchtop)
ProFill 324 (benchtop)

Molds

ProMold TTM (Tablet & Triturate)
ProMold TLM (Lozenge & Troche)
ProMold RDTM (Rapid Dissolve Tablet)

Other Equipment

ProFunnel (filling funnel)
ProMixer (Powder Blender)
ProCoater (Enteric Capsule Coater)
ProTDM (Tap Density Meter)

My INTENDED Use of the Above Is In:

Vet Pharmaceutical Use:

Veterinary Product Manufacturer
Veterinarian Clinical Use
Pre-clinical / Toxicology Use
Rodent / Guinea Pig
Veterinary Distribution of Empty Capsules

Human Pharmaceutical Use:

Clinical Trials
Nutritional / Herbal Manufacturing
Rx Drug Manufacturing
Compounding Pharmacy
Distributor

Non-Pharmaceutical Use:

Optics/Storage
Medical Devices
Toy
Special Effects
Other:

Please quote on the following:

(Provide full details for a fast & accurate quote)

Please quote on the following:

Capsules (specify order quantity, size, color of cap/body, quantity/bag, prefered delivery time.)

Machines (specify machine type, capsule sizes to fill, prefered delivery time.)

Additional Comments:

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Capsules, Fillers, Mixers & Molds. www.torpac.com & www.profiller.com

Torpac Inc., 333 Route 46, Fairfield, NJ 07004, USA
Tel: +1-973-244-1125 USA Eastern Time * Fax: +1-973-244-1365
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Torpac Europe BV, Jan Camperstraat 19, 6416 SG Heerlen, The Netherlands
Tel: +31-6-30-93-65-27 GMT+ 1:00

ProFiller^®& Torpac^® are registered marks of Torpac Inc.
ProCoater™ - ProMixer™ - ProFunnel™ - ProTRM™ - ProMold™ are trademarks of Torpac Inc.
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