| Your Address |
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| Your Name |
| Your daytime phone |
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| Card #, Expiration Date |
| Signature |
| QUANTITY and SIZE |
PRODUCT | PRICE | AMOUNT |
|---|---|---|---|
| Breezy Over Shoulder Blanket 38" - 46" |
399.00 | ||
| Breezy Over Shoulder Blanket 48" - 66" |
699.00 | ||
| Breezy Over Shoulder Blanket 68" - 80" |
749.00 | ||
| _ | Breezy Over Shoulder Blanket 82" - 88" |
820.00 | _ |
| Magnetic Bell Boots -Indicate S or M (Up to 14.3 Hands) |
74.00 | ||
| _ | Magnetic Bell Boots -Large (15 Hands and Up) |
74.00 | _ |
| _ | Magnetic Brow Band - One Size | 48.00 | _ |
| _ | Magnetic Cannon Boot - Pair | 169.00 | _ |
| Magnetic Cannon Boot - Indicate R or L | 99.00 | ||
| _ | Magnetic Fetlock/Pastern - Pair | 169.00 | _ |
| _ | - Indicate R or L | 99.00 | _ |
| _ | Magnetic Hock Boot - Pair | 189.00 | _ |
| _ | Magnetic Hock Boot - Indicate R or L | 99.00 | _ |
| _ | Magnetic Knee Boot - Pair | 159.00 | _ |
| Magnetic Knee Boot - Indicate R or L | 99.00 | ||
| SNM Magnetic Band - 2" x 12" | 30.00 | ||
| SNM Magnetic Cuff - One Size | 73.00 | ||
| _ | Sore No More Liniment, 16 oz | 19.95 | _ |
| QUANTITY and SIZE |
NUMBER | DESCRIPTION | RETAIL | AMOUNT |
|---|---|---|---|---|
| _ | Active | Active Back | 37.00 | _ |
| _ | 20000 | Ankle Support | 20.00 | _ |
| _ | 90003 | Car Seat | 72.00 | _ |
| _ | 60002 | Card Magnetic 2 Pk, 2" x 3.25" | 22.00 | _ |
| _ | Lumbar | Deluxe Lumbar Support -- indicate S/M or L/XL |
56.00 | _ |
| _ | 30001 | Elbow Support -- indicate S/M or L/XL |
20.00 | _ |
| _ | Eye | Eye Mask | 13.00 | _ |
| _ | 1000 | Facemask | 64.00 | _ |
| _ | 2000 | Flat Insole - Men --indicate size 9, 10, 11, 12 |
26.00 |
_ |
| _ | 2001 | Flat Insoles -Women --indicate size 6, 7, 8, 9, 10 |
|
_ |
| _ | 50000 | Flex Magnetic Pad 7.5" x 5.5" | 54.00 | _ |
| _ | 3005 | Head Band | 19.00 | _ |
| _ | 1000 | Knee Stablizer -- indicate S/M or L/XL |
33.00 | _ |
| _ | 70000 | Magnetic Mitt | 24.00 | _ |
| _ | 2000-O | Magnetic Orthotics - Men --indicate size 9, 10, 11, 12 |
49.00 |
_ |
| _ | 2001-O | Magnetic Orthotics -Women --indicate size 6, 7, 8, 9, 10 |
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_ |
| Magnetic Strip 2" x 7" | 45.00 | |||
| _ | E-9001 | Mattress Full Overlay | 350.00 | _ |
| _ | E-9003 | Mattress King Overlay | 560.00 | _ |
| _ | E-9004 | Mattress Personal Size Overlay | 142.00 | _ |
| _ | E-9002 | Mattress Queen Overlay | 435.00 | _ |
| _ | E-9000 | Mattress Twin Overlay | 234.00 | _ |
| _ | 60001 | Max-Circle Magnetic Pad 3.5" Dia. | 27.00 | _ |
| _ | A-2 | Max Circle Adhesive Pk of 30 |
9.00 | _ |
| _ | 60000 | Mini Magnetic Circle 2 Pk 1.5"Dia. | 26.00 | _ |
| _ | A-1 | Mini Circle Adhesive Pk of 30, Small |
5.00 | _ |
| _ | Neck | Neck Collar 30" x 3.5" | 29.00 | _ |
| PPM | Pet Pad Medium (21 x 29) |
49.00 | ||
| PPL | Pet Pad Large (29 x 41) |
83.00 | ||
| _ | Shin | Shin Support 7.25" x 4" | 26.00 | _ |
| _ | 3009 | Shoulder Support | 29.00 | _ |
| _ | Thigh | Thigh Support 26" x 6" | 32.00 | _ |
| _ | Thumb | Thumb & Wrist Support | 19.00 | _ |
| _ | WristS | Wrist (Splint) -- indicate R or L |
19.00 | _ |
| _ | 30000 | Universal (Tennis) Elbow Wrap | 13.00 | _ |
| _ | Universal | Universal Kit | 28.00 | _ |
| _ | 40000 | Universal Wrist Wrap | 13.00 | _ |
Don't see the size you are looking for? Call us, and we will custom buiild any item to your specifications!
Notes/Comments/Instructions
| $0 - $25.00 | $5.00 |
| $25.01 - $60.00 | $6.00 |
| $60.01 - $120.00 | $8.00 |
| $120.01 - 200.00 | $9.00 |
| $200.01 - $400.00 | $10.00 |
| $400.01 - $500.00 | $12.00 |
| Over $500.01 | $15.00 |
| Total Amount |