PRP Order Form

PRP Order Form

Please make sure to fill in the required fields and submit this form to complete your order.

My Products

TRU Medical PRP 12ml Kit

Includes all draw accessories

$99.00 Quantity
Item subtotal:$0.00

TRU Medical PRP 15ml Kit

Includes all draw accessories

$115.00 Quantity
Item subtotal:$0.00

Hyaluronic Acid + PRP Kit

2 - 10ml Tubes with HA Blood draw accessories

$199.00 Quantity
Item subtotal:$0.00

Biotin+PRP Kit

2 - 10ml Tubes + Blood draw accessories

$149.00 Quantity
Item subtotal:$0.00

4x 12ml Tubes

4 individually wrapped tubes

$179.00 Quantity
Item subtotal:$0.00

1x 30 ml PRP Tube

one individually wrapped 30ml PRP tube

$88.00 Quantity
Item subtotal:$0.00

PRP Blood Draw Accessories

1 set of of sharps for PRP medical kits

$5.00 Quantity
Item subtotal:$0.00

PRP Blood Draw Accessories 30 ml

1 set of of sharps for PRP medical kits

$8.00 Quantity
Item subtotal:$0.00

VitalitySpin CENT8 Centrifuge

• Rotor Accepts up to Eight Prep Tubes • Variable Speed: 100 – 4,000 RPM • Digital Timer 0-99 Min • Lid Safety Lock • Rotor Unbalance Sensor • Super Quiet • 1 Year Limited Warranty

$799.00 Quantity
Item subtotal:$0.00

CENT6XL Centrifuge (for 30ml Tubes)

• Rotor Accepts up to Six Prep Tubes • Variable Speed: 100 – 4,000 RPM • Digital Timer 0-99 Min • Lid Safety Lock • Rotor Unbalance Sensor • Super Quiet • 1 Year Limited Warranty

$1,450.00 Quantity
Item subtotal:$0.00

Plasma Bio- Incubator

Accepts up to 10 Syringes Digital Read Out Timer Settings from 0-99 Min Temperature Settings from 0-90 degrees Syringe Sizes: 1ml, 2ml, 3ml, 4ml, 5ml 1 Year Limited Warranty

$4,950.00 Quantity
Item subtotal:$0.00

Derma Pen A6 Micro Needling + 2 12 pin Cartridges

$99.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Full Name

First NameLast Name
E-mail
example@example.com
Contact Number
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is shipping address same as billing address?

YesNo
Shipping Adress

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shipping Options*

Ground $152 Day $40Overnight $60
NPI#*
Referred by
Should be Empty: