Wound Care Order

Download PDF version

Wound Care Order

"*" indicates required fields

Company Name*

PO#

Ordered By*

First Last

Email*

Ship To Address

Ship To Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Bill To Address

Bill To Address*

Same as previous

Order Notes

Patient*

NEGATIVE PRESSURE WOUND THERAPY

Wound Vac (Product Code: A4-S0003 PKG: 1 Units: each)*

Please enter a number from 0 to 100.

400cc Canister (Product Code: A4-S00D4 PKG: 10 Units: box)*

Please enter a number from 0 to 100.

Spiro Foam Dressing Kit (Product Code: XF-SPMK1 PKG: 10 Units: box)*

Please enter a number from 0 to 100.

Bridge Dressing Kit (Product Code: XF-BKMF1, PKG: 10 , Units: box)*

Please enter a number from 0 to 100.

Medium Thick Foam Kit (18 x 12.5 x 3.3 cm) - (Product Code: XF-DMDF1, PKG: 10, Units: each)*

Please enter a number from 0 to 100.

Medium Thin Foam Kit (15 x 10 x 2 cm) - (Product Code: XF-DMDF1-T, PKG: 10, Units: each)*

Please enter a number from 0 to 100.

Large Thick Foam Kit (26 x 15 x 3.3 cm) - (Product Code: XF-DLGF1, PKG: 10, Units: box)*

Please enter a number from 0 to 100.

Y Connector (Product Code: A4-S00Y2, PKG: 10, Units: box)*

Please enter a number from 0 to 100.

Drape (Product Code: XF-DLGF1-T, PKG: 10, Units: box)*

Please enter a number from 0 to 100.

Port Pad - (Product Code: XP-1012, PKG: 10, Units: Pack)*

Please enter a number from 0 to 100.

White PVA Foam (10 x 15 x 1 cm) - (Product Code: XF-PVAFOAM1, PKG: 5, Units: Pack)*

Please enter a number from 0 to 100.

Varity Pack (3 medium thin, 3 medium thick, 3 Spiro, 3 Bridge) - (PKG: 12, Units: box)*

Please enter a number from 0 to 100.

New Patient

Tabor Medical

2142 North Fine Avenue,
Fresno, California 93727

Contact Us

Drop us a line!



success@tabormedical.com



888-988-2267



559-392-6459

2142 North Fine Avenue, Fresno, California 93727



We are available 24X7

Request a Quote

Company Name(Required)

Name(Required)

Email(Required)

Phone(Required)

Address(Required)

Message(Required)