Field Medix
We at Field Medix understand that the business of technology can be frustrating. This is why we offer a range of services that are designed to make our customers life easier.
Our complete service organization offers Field Services, Network Cabling, Local and Wide Area Network's, Closed Circuit Television (CCTV), Audio Visual (AV),  Printer Repair, Depot Repair, Inventory Management as well as Parts Warehousing and Distribution.
Whatever industry, whatever the size of the company, we will bring a high quality of service and a secure solution that is easy to implement and use.
ASP Program


Authorized Service Provider Application

Field Medix requires that all Authorized Service Providers (ASP) complete and regularly update the following qualification profile so that we can appropriately assign service calls and solicit new business. Although manufacturers' certifications are not required, they are becoming increasingly important to many customers so please pay particular attention to the certification section. There are no correct answers.

Company Name:

Contact Name: *

Address 1: *

Address 2:


State/Province: *

Zip/Postal Code: *

Country: *

Main Phone Number: *

After Hours Phone Number: *

Web Site:


Onsite Response Time: (Check all that you can supply) 

7x24 - 4 Hour Response
7x10 - 4 Hour Response
5x10 - 4 Hour Response
4 Hour
Next Business Day
After Hour Response
Weekend Response

Union Affiliation (Check all that apply)


Length Of Time In Business: *


Number of Technicians: *

Do all Techs have a Valid Drivers License: *

If "Yes", please E-Mail a copy to

Do all Techs have Valid Car Insurance: *

If "Yes", please E-Mail a copy to

Business License Number:

Low-Voltage License Number:

Are you and/or your company covered by Workman's Compensation: *

Are you and/or your company covered by Liability Insurance: *

If "Yes", please E-Mail a copy to

Do you operate out of a shop or store front where someone is available during normal business hours to accept carry-in units for depot repair: *

Do you and/or your company have or held a security clearance: *

Is you and/or your company you bondable: *

Do you or your Techs have or held any FAA badges: *

Any of the Techs Sub-Contractors: *

Coverage Areas 

Zip Code:

Radius Covered (In Miles):

Do you wish to add more Zip Codes:

Submitter Information 

Name: *

Title: *

Phone: *

E-Mail: *

By submitting this application to Field Medix,
you certify that the information is truthful and accurate to the best of your knowledge and authorize Field Medix to verify the information provided.

Security Code: *

Field Medix offers extensive partnership opportunities for companies and individuals intrested in expanding their portfolio with additional value-added services or expanding the geographies they can service while enjoying higher margins.

Field Medix Authorized Service Provider Program 

Field Medix delivers onsite service to customers throughout North and South America as well as the Caribbean. We have developed a scalable field service model using both internal field engineers and Authorized Service Providers (ASPs) to serve our customers professionally and ensure the highest quality of service delivery.

An ASP is an individual or company that has demonstrated a solid understanding of in any of the technology fields while, possessing the tools necessary to complete service calls, and has successfully completed Field Medix ASP training courses on our call procedures, ASP expectations and commitment to quality and service. To ensure consistent quality and service excellence, we hold our ASPs to the same high standards we expect of our internal field force and expect them to meet their commitments, possess excellent customer relations skills and project a professional image.

Field Medix ASPs play a very important role in the delivery of quality service to our customers to augment our internal field resources. If you or your company is interested in becoming a FIELD MEDIX ASP, please submit an application. Your application will be reviewed and a representative will contact you to discuss the program in further detail.

 Submit an Application to Become an ASP

 Login to Our ASP Pages 

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