Otomed - Order Form

ORDER FORM: products & quantities

CAT. # DESCRIPTION PRICE QUANTITY

A-700 Sheehy Collar Button, Teflon® Details $48.00 Box of 6

S-100 Sheehy Cutting Block, Teflon® Details $48.00 Pkg of 1

S-2500 Sheehy Bone Dust Collector Details $37.00 Pkg of 1

S-3500 Cox Bone Dust Collector Details $75.00 Pkg of 1

SP-2000 SafeTrap Tissue Collector Details $27.00 Pkg of 1

SP-3000 Levine Irrigation-Suction Kit Details $212.00 Box of 6

SP-4000 OTOMED Suction Tubing Details $77.00 Box of 6

SD-2100 Glasscock™ Otology Surgery Drape Details $164.00 Box of 6

SD-2200 Glasscock™ Neurotology Surgery Drape Details $219.00 Box of 6

S-1000 Glasscock™ Ear Dressing Kit, Adult Size Details $74.00 Box of 6

S-1003 Glasscock™ Ear Dressing Kit, Pediatric Size Details $74.00 Box of 6

S-1001R Glasscock™ Postauricular Bandage, Right Details $25.00 Box of 6

S-1001L Glasscock™ Postauricular Bandage, Left Details $25.00 Box of 6

S-1010-2 Head & Neck Pressure Dressing - 3" Non-Conforming Details $59.00 Box of 6

S-1010-3 Head & Neck Pressure Dressing - 3" Conforming Details $56.00 Box of 6

PS-0100 Tierney Otoplasty Dressing Details $57.00 Box of 3

S-5000 OTOMED Eye Protector Details $8.50 Pkg of 1

OTO-100 Ear Wicks Details $50.00 Box of 25

S-800 OTOMED Instrument Wipes Details $14.00 Box of 12

S-3001 Sheehy-House Powder Insufflator Details $14.00 Pkg of 1

S-7002 OTOPlug Ear Plugs, Individual Set, Pediatric Details $3.00 Pkg of 1

OTOPlug Ear Plugs, Individual Set, X-Small $3.00 Pkg of 1

OTOPlug Ear Plugs, Individual Set, Small $3.00 Pkg of 1

OTOPlug Ear Plugs, Individual Set, Medium $3.00 Pkg of 1

OTOPlug Ear Plugs, Individual Set, Large $3.00 Pkg of 1

OTOPlug Ear Plugs, Individual Set, X-Large $3.00 Pkg of 1

All contents © OTOMED, Inc.

1090 Empire Drive • Lake Havasu City, AZ 86404
PHONE (800) 433-7703 • FAX (928) 453-3809 • EMAIL info@otomed.com

Your Order

Qty

Product

Cost

Subtotal:

$0.00

Minimum Order $35.00

Providing effective &
efficient products

3 WAYS TO ORDER
ON-LINE

Choose your products and quantities in the boxes to the left. Click the “Check Out Now” button to continue.

FAX

Choose your products and quantities as above and click the “Check Out Now” button. On the next page, click "Print Order" to print your completed, faxable order form.

TELEPHONE

Orders may also be placed by calling us toll-free (800) 433-7703 Monday - Friday.

Products are sold only to physicians, hospitals and medical facilities.

A confirmation of your order including shipping and handling will be sent within two business days.

TERMS: Net 30 days,
FOB Lake Havasu City, AZ,
Minimum Order $35.00.

View complete TERMS & CONDTIONS