Varitronics' Ophthalmic Disoposables:Order Form

Varitronics Inc.
Leading the way with innovative product design.

To order by credit card call 1-800-345-1244.

Purchase Order Form for Drape Retractors, Eye Dentifiers, and Medication Labels.


    Name of Institution: 
                Address: 
                                 
       City, State, Zip: , , 

                  Phone:   FAX: 
                  Email: 

      Person to contact: 
  Purchase Order Number: 
               Comments: 


Nevyas Drape Retractors: $22.00 per pack.

        Number of Packs:  Sold 24 per pack with a 4 pack minimum.

Eye Dentifiers: $22.00 per pack.

        Number of Packs:  Sold 5 sheets of 50 labels per pack with no pack minimum.

Standard Ophtalmic Medication Labels: $11.25 per pack.

        Number of Packs:  Sold 25 sheets of 500 labels per pack with no pack minimum.


               Shipping: 


Confirmation by Invoice. Terms Net 30. No sales tax except California, Florida, and Pennsylvania.