Southern Implants EthOss Online Ordering Form

Ethoss Online Ordering Form

5% discount on 1-4 boxes

10% discount on 5-9 boxes

15% discount on 10+ boxes

Southern Implants Account Name*

Southern Implants Account Number*

For example, "AB123"

Full Name*

First NameLast Name

E-mail*

example@example.com

Phone Number*

Title*

Address to reflect on invoice*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PLEASE PLACE YOUR ORDER HERE*

270000 | Ethoss Synthetic Bone Regeneration 3 x 0.5ccExcluding GST

$741.00AUD Quantity

270001 | Ethoss Synthetic Bone Regeneration 3 x 1.0ccExcluding GST

$883.50AUD Quantity

Subtotal

$0.00AUD

Tax

$0.00AUD

Shipping

$0.00AUD

Total

$0.00AUD

Please be aware that a 1.7% Stripe processing fee will be automatically added to your purchase.

Notes/Comments

If there are any other enquiries or if further assistance is needed, please don't hesitate to contact us!

wa@southernimplants.com.au

WA (08) 9466 2627 | NSW (02) 8076 9337

www.southernimplants.com.au