Ear-mart Order Form

SECURE ORDER FORM

1. Please have your CREDIT CARD (MasterCard, VISA) available before filling out the order form.
2. Enter the QUANTITY of items on the order form.
3. Press the COMPUTE TOTALS button to recalculate all totals at any time.
4. Fill in the ORDERED BY and METHOD OF PAYMENT sections.
5. PRINT OUT this order form for your records.
6. Click the SEND ORDER button to submit your order.

CAT#	PRODUCT	PRICE	QTY	TOTAL

EAR HEALTH-DIETARY SUPPLEMENTS
	Ear-Vite PLUS® 120 tablets per bottle
80202	1 - 2 Bottles	$30.00/Bottle
80202	3 or More Bottles	$27.00/Bottle


EAR WAX REMOVAL PRODUCTS
	Ear Wax Removal Drops 0.5 Fluid oz. (15 ml) bottle FREE Ear Putty Ear Plugs
60202	1 - 2 Bottles	$4.99/Bottle
60202	3 or More Bottles	$4.50/Bottle

	Ear Wax Removal Kit 0.5 Fluid oz. (15 ml) bottle FREE Ear Putty Ear Plugs Bulb syringe
60204	1 - 2 Kits	$5.99/Kit
60204	3 or More Kits	$4.99/Kit

	Deluxe Ear Wax Removal Kit 0.5 Fluid oz. (15 ml) bottle FREE Ear Putty Ear Plugs Bulb syringe Ear basin
60206	1 - 2 Kits	$7.99/Kit
60206	3 or More Kits	$6.99/Kit


ALL NATURAL EAR WAX REMOVAL PRODUCTS
	Deluxe All Natural Ear Wax Removal System with Multi-Flow Ear Cleansing Tip 1 Fluid oz (30 ml) bottle and bulb syringe with Multi-Flow Tip
60506	1 - 2 Kits	$8.99/Kit
60506	3 or More Kits	$7.99/Kit

	All Natural Ear Wax Removal System 1 Fluid oz (30 ml) bottle and bulb syringe
60502	1 - 2 Kits	$7.99/Kit
60502	3 or More Kits	$6.99/Kit

	All Natural Daily Ear Wash 20 treatment packets and squeeze bottle with temperature sensor and spray tip
60504	1 - 2 Kits	$9.99/Kit
60504	3 or More Kits	$8.99/Kit


NOISE PROTECTION PRODUCTS
	Clean Fit™ Foam Ear Plugs 10 Pair of Foam Ear Plugs
30400	1 - 2 Packages	$3.99/Package
30400	3 or More Packages	$3.33/Package

	Clean Fit™ Foam Ear Plugs 50 Pair of Foam Ear Plugs
30450	Jar of 50 Pair	$11.99/Jar


WATER & NOISE PROTECTION PRODUCTS
	Silicone Ear Putty® Ear Plugs Bulk Case - 3 pair of Ear Putty Ear Plugs per case
30107	3 pair per case/12 cases per box	$30.00/Box

	Silicone Ear Putty® Ear Plugs 4 Pair of Ear Putty Ear Plugs
30108	1 - 2 Packages	$3.99/Package
30108	3 or More Packages	$3.50/Package

	Swimmer’s Ear Drying System 2 Fluid oz. (60 ml) bottle, plus FREE Ear Putty Ear Plugs
60100	1 - 2 Kits	$5.99/Kit
60100	3 or More Kits	$5.50/Kit


HEADBANDS
	Neoprene Head Bands
41206	Head Bands Small: 1-4 years	$11.95/Each
	Available Colors: Pink, Purple, Red, Royal Blue, & Teal	Choose Color


41207	Head Bands Medium: 5-10 years	$11.95/Each
	Available Colors: Pink, Purple, Red, Royal Blue, & Teal	Choose Color:


41208	Head Bands Large: 11- Adult	$11.95/Each
	Available Colors: Pink, Purple, Red, Royal Blue, & Teal	Choose Color:


41209	Head Bands X-Large - (head size 7.25+)	$12.95/Each
	Available Colors: Red & Royal Blue	Choose Color:







Sub-Total:
Shipping:
	(Shipping available within 48 contiguous states only. Residents of Alaska and Hawaii, please contact us for rate information)
TOTAL:

ORDERED BY: *Required
Please indicate gender and age group for the person(s) who will be using the product. Gender (optional): Male Female Age: 1-4 years, 5-10 years, 11-18 years, Over 18 years. How did you hear about us? Google Ad General Internet Search Other Internet Doctor Recommended Friend Recommended TV Ad Newspaper Ad Journal Ad Radio Ad Other Ad This information is needed to fill your order correctly, and will not be given or sold to any group.
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SHIP TO: Same as ORDERED BY Yes No
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METHOD OF PAYMENT
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*Exp. Date:
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Print a copy of this order for your records before sending. Order will only be sent when you click on Send Order.

ADDITIONAL ORDERING INFO PAYMENT We accept Visa and MasterCard. Your credit card is charged when the order is filled. Payment accepted in US funds only. SHIPPING POLICIES AND RATES We ship only to street addresses in the United States (No PO Boxes). All orders are shipped via UPS Ground from Minnesota. Alaska, Hawaii and International residents should contact us for shipping charges. RETURNS If you are not completely satisfied, we'll gladly refund the purchase price. Return unused merchandise by insured Parcel Post or UPS within 30 days of purchase. Shipping charges are not refundable. TO CONTACT ear-mart.com: Your feedback helps us improve our site for you and we encourage you to send us your comments. You can contact ear-mart.com in the following ways: E-mail: customerservice@micromedics.com Phone: 1-800-624-5662 or 651-452-1977 Fax: 1-888-504-0606 or 651-452-1787 Mail: Santa Barbara Medco, Inc. 1270 Eagan Industrial Road St Paul, MN 55121 USA PRIVACY POLICY At ear-mart-com, we respect your right of confidentiality and are committed to protecting your privacy. We protect your account information against unauthorized access or release. We will not sell, rent or loan any identifiable personal information to any third party. We may share non-personal, summary or aggregate customer data with partners and other third parties. TERMS OF SITE All content included on this site, such as text, graphics, logos, images and software, is the property of ear-mart.com or its content suppliers and protected by U.S. and international copyright laws. Reproduction, modification, distribution, transmission, republication, display or performance, of the content on this site is strictly prohibited.

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