Case Order Form

1
Name and TikTok/Discord Handle* This field is required.
First Name
TikTok/Discord Name
2
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Insert Configuration* This field is required.ONLY AVAILABLE ON THE 60 AND 100 CASE! (Adding these options removes 3ml vial slots) (Syringes and wipes not included)
3ml vials
3ml + 10ml vials (Nad, BAC water etc)
“Travel case” (Vials + Syringes/Wipes) (this option is only available in the 60 vial size)
4
Select case size* This field is required.Cases start at $30 and go up from there depending on configurations and customizations. Prices include shipping
30 vial ( $35)
60 vial ($65)
100 vial ($85)
10 vial ($15 no custom options)
FREE CASE (You spent $500+ with my code *screenshot required*)
5
Would you like a custom logo?If yes, upload screenshot of what you want.
Yes
No
6
Upload desired logoDepending on the complexity of the logo, it may not be possible to add to a case.
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
Cancelof
7
Order ConfirmationONLY FOR FREE CASE. Skip if this doesn’t apply to you! Upload your order confirmation showing you spent $500+ with my code
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
Case SpecificsDescribe what you want done with your case (vial count, syringes (vial count doesn’t matter when syringes are in there. I can only fit so many) top color, bottom color, latch and insert colors, etc)
Huge
Large
Normal
Small
Ok
Ok
9
Due to limitations on logos, colors etc. this case order is NOT FINAL.

Please fill out this form, then message me on discord or TikTok so we can look it over. I want to be sure that I am producing a quality product for you and you are getting what you want because let's be honest, I know I'm not the cheapest case out there. That's not my goal.

I do my best to check the cases for any defects or mistakes and often times reprint the case if that happens. I am a perfectionist and my work reflects that.

Thank you for your support!

Once you hit submit, you will be redirected to the discord!
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