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T&E Requests

If your agency is interested in obtaining Eleven 10® products for test and evaluation, complete the form below. Required fields are marked with a red asterisk. A representative from Eleven 10® may contact the agency for confirmation. T&E Samples will only be shipped to an agency address and will be fulfilled on a first-come, first-serve basis. The T&E period is 20 days, after which the products must be returned to Eleven 10®. We ship all samples to you via UPS Ground and include a return shipping label.

Our T&E samples are meant to be tested and evaluated. Please don't worry about actually using and abusing the products. On the same token, the samples you receive may show signs of use.

The samples do not normally include medical devices. If your agency needs the tourniquets or medical contents, please make a note of that in the comments section.

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