Sedation Stethoscope Adapter Request

Right-Angled Adapter Request
Thank you for your interest in the NEW Sedation Stethoscope Right-Angled Adapter.

Please complete the form below, and we will mail an adapter to you free of charge.

If you own more than one Sedation Stethoscope, please indicate the quantity below and include an image of each of your sets.

We look forward to providing you with this new enhancement!

All questions with a red asterisk * must be completed before submitting the form.
Email Address*
example@example.com
Doctor's Name*

First NameLast Name
Practice Name*
Account Number (if available)
If you purchased your Sedation Stethoscope from a distributor instead of Sedation Resource, please indicate the name of the distributor below.
Ship To Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Quantity of Adapters Requested (only one adapter per Sedation Stethoscope set)*
Upload an image of your Sedation Stethoscope sets*

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Right-Angled Adapter Request