StoMedical 
Order Form

To place an order, print this order form, and mail it to:
StoMedical LLC
P.O. Box 722005
San Diego, CA 92172-2005

or for immediate response, call 800-814-4195 for a Visa or MasterCard purchase.

All non-disposable products have a six month warranty on material and workmanship.  StoMedical LLC disclaims the ability of any of the products to protect any area from harm that results from unreasonable force.  The company does not by implication or other statements imply any responsibility for harm caused while using the above named products.  These products are not intended for anything other than comfort.

Shipping and Handling:   $4.00__________

Total__________

Personal Check             Visa                 MasterCard Remember to include your waist measurement!

Card Number:_________________________________

Expiration Date:_______________________________

Name:_______________________________________

Address:_____________________________________

City:____________  State:____Zip Code____________

Phone Number: _______________________________

 

Mail or call your order in to:
StoMedical LLC
P.O. Box 722005
San Diego, CA 92172-2005
800-814-4195