REQUEST FORM

To request information or have a sales representative contact you, please fill in the form below. (items are marked with an * are required.)

We respect your privacy. The information you provide will only be used to provide you with information on Baxter programs and service. When you submit personally identifiable information you consent to its disclosure and use for these purposes. If you ever decide that you do not wish to receive information from us, contact us at: Consumer Relations, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015 or at 800-423-2090. If you have any questions, comments, concerns or complaints about our information practices, call 1-800-422-9837 (U.S.) or 847-948-4770 (outside of the U.S.), fax your inquiry to 847-948-3642, or send us mail at Center for One Baxter, One Baxter Parkway, Deerfield, IL 60015.

This information is intended only for residents of the United States.