Eye Care Order Form

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R3 Eye Care Order Form

 

  • Account Information

  • Products to Order - Amniotic Membrane 1x1cm

    Minimum Order is 5 units

    Quantity Per Order Pricing
    5 to 9 = $160 each
    10 to 25 = $145 each
    26 to 49 = $130 each
    >50 = $120 each
    **No Tax and Shipping is Included
  • Shipping Instructions

    All orders are shipped either via Fedex or UPS Ground or Priority USPS, unless otherwise requested
  • Please enter any unique instructions for this order.

 

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