Accessories Order Form

First Name *
Last Name*
Phone Number*
Email*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How did you hear about Daavlin?
Other
Accessories
prevnext( X )
1 Series StandHome phototherapy unit accessory
$150.00 Quantity



7 Series CastorsHome phototherapy unit accessory
$80.00 Quantity



7 Series Wall Mount KitHome phototherapy unit accessory
$80.00 Quantity



M Series TableHome phototherapy unit accessory
$550.00 Quantity



DermaPal Replacement CombHome phototherapy unit accessory
$60.00 Quantity



Levia LiteSpot AttachmentHome phototherapy unit accessory
$200.00 Quantity



Levia Carrying CaseHome phototherapy unit accessory
$138.00 Quantity



Sliding Template (for LiteSpot)Home phototherapy unit accessory
$35.00 Quantity



Replacement ManualHome phototherapy unit accessory
$20.00 Quantity



Replacement Time Chart / Back-Up Time ChartHome phototherapy unit accessory
$5.00 Quantity



DermaPal CombHome phototherapy unit accessory
$60.00 Quantity



Phototherapy Light Template / StencilHome phototherapy unit accessory
$4.00 Quantity



Levia LiteBrush AttachmentHome phototherapy unit accessory
$467.00 Quantity



Levia Replacement USBHome phototherapy unit accessory
$20.00 Quantity



UltraSonic Cleaner (for LiteBrush)Home unit care accessory
$30.00 Quantity



Disinfectant Wipes (80pk)Home unit care accessory
$20.00 Quantity



Levia Wire Cleaning Brush (for LiteBrush)Home unit care accessory
$2.00 Quantity



Fitover Glasses (Amber)UV Protective Eyewear
$19.95 Quantity



Fitover Glasses (Clear)UV Protective Eyewear
$19.95 Quantity



Fitover Glasses (Smoke)UV Protective Eyewear
$19.95 Quantity



Fitover Glasses (Yellow)UV Protective Eyewear
$19.95 Quantity



Sperti Goggles (Green)UV Protective Eyewear
$7.50 Quantity



Sperti Goggles RedUV Protective Eyewear
$7.50 Quantity



Super Sunnies (Multi-color)UV Protective Eyewear
$4.50 Quantity



Daavlin Lip Balm SPF15Personal Care Item
$2.00 Quantity



Mineral Treatment Oil (2oz)Personal Care Item
$6.00 Quantity



Total

$0.00
Order Confirmation

By entering my name I hereby confirm the above order is accurate and complete to the best of my knowledge. Daavlin will contact me for information regarding my payment method before my order will be finalized.
Name*
Date*

MonthDay Year
Date
Should be Empty: