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To order the Lavin Lift Strap, just print out this form, complete it, and send it with a check or money order to: P.O. Box 91 Belleville, MI 48112-0091 If you wish to invoice a business account, or if you have any questions, please call toll free: (888)545-5438 |
| The Lavin Lift Strap is an adjustable strap made of foam-padded nylon and Velcro™, and will secure your patient in comfort. |
SIZING |
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Strap Size |
12 |
14 |
16 |
18 |
20 |
fits Leg Size* |
13" or less |
14-15" |
16-17" |
18-19" |
20" or more |
| *Measure the circumference of the leg at 3 inches above the knee. | |||||
SHIPPING FEES* |
||
1-2 pairs |
3-5 pairs |
5-10 pairs |
$3 |
$4 |
$5 |
| *Please call to make shipping arrangements for larger orders. | ||
ORDER FORM |
||
Strap Size |
# of Pairs at this size |
x $99.95 (per Pair) |
| 12 | ||
| 14 | ||
| 16 | ||
| 18 | ||
| 20 | ||
| SUBTOTAL = $ | ||
| + 6‰ sales tax | ||
| + shipping fee | ||
| TOTAL: $ | ||
SHIPPING INFORMATION | |||
| Name: | |||
| Company Name: | |||
| Shipping Address: | |||
| Phone: | E-mail: | ||
| How did you hear about us? | |||
© Copyright 1998 Spinster Design.