Starting a new  account 

To open a new account with us just download the two forms provided below (mailing label and prescription form) and send them with your case.  To receive a complementary introductory kit, please complete the online form below and we mail you starter kit. Your account will be made upon arrival of your order. An invoice with balance will be sent monthly via email.  

Click here to Download 

Click here to Download 

Click here to Download

Click here to Download

Requesting Your Complementary Introduction Kit: 

Name *
Address *
Phone *
Fax Number *
Fax Number

Payment Methods:

  • Invoices for accounts totaling all balances will be sent at the end of each month.
  • Payments are due within 15 days of the invoice date.
  • Payments made surpassing the 15 days will be subject to 1.5% per month service charge (18% annual rate).
  • We accept payment in the form of checks or credit cards (including MasterCards and Visa Cards).
  • For any international orders, payment must be made at time of order and with qualifying credit card. 

Shipping Method:

  • Shipping to the continental regions of the United States is $6.00, Canada is $18.00, and for international orders please call (602)-688-9099 for further assistance. 
  • Shipping costs will be incurred b the account holder for shipments with less than three cases.
  • Shipments with order over three cases, shipping will be free. 
  • In emergencies or rush cases, rush delivery is possible via UPS Next Day Air®, UPS 2nd Day Air® or UPS 3-Day Select®, please call (602)-688-9099 in advance for additional charges.

Turnaround Time:

  • Labratory processing time is typically 24 hours to make new appliances, if another time is quoted account will be notified. 


*All prices are subject to change*