NAME *

ADDRESS

ADDRESS2

CITY

PROVINCE

COUNTRY

POSTAL CODE

PHONE

FAX

EMAIL*
|
I'M INTERESTED IN:
Solarc/SolRx 1000 Series Full Body Panel
Solarc/SolRx 500 Series Hand/Foot & Spot Unit
Solarc/SolRx 100 Series Hand-held
Used Phototherapy Equipment
Replacement Ultraviolet Lamps

I AM:
Currently taking phototherapy at a
clinic/doctor's office.
A former phototherapy clinic user.
It became too difficult to keep up.
Too far from a phototherapy clinic.
Just curious...
A phototherapy clinic looking for replacement bulbs.
VERY INTERESTED !
Please have someone call me ASAP
If you need a hardcopy of any information,
we ask that you download it from our
Download Center.
If you are having trouble downloading,
we would be pleased to mail you whatever you need.
Just send us a note below:
|