Delasco Preferred Program
Fill out the information below and a Delasco Expert will be in touch.
What procedures do you perform in your practice?
Have you placed an order with Delasco in the past 12 months?
Who do you currently purchase dermatology supplies from?
Are you opening a new practice or expanding your practice to a new location in the next 12 months?
Are you an active member of these associations (choose all that apply)?
International Peeling Society (IPS)
American Society of Dermatologic Surgery (ASDS)
How did you hear about the Delasco Preferred Program?
Delasco Account Manager
Delasco Social Media
Please list the best days/times for our team to contact you:
Example: Mondays & Wednesdays from 4-5 pm CST.
Please verify that you are human
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