PURCHASE

Licensed Medical Professionals

Prior to shipping cold laser equipment we determine if you are a licensed medical professional. We do so by searching the national NPI database and other sources. If we are not able to determine if you are a Licensed Medical Professional we will call to ask you to fax us a copy of your professional license or provide your NPI number in order to allow us to process and ship your order. In order to avoid any delay you may FAX the above information to Laser-Therapy at (480) 393-4489.


If you are NOT a Licensed Medical Professional

Please print out this form, fill in the blanks and FAX to: (480) 393-4489



____________________________________ (your name)



____________________________________ (your street address)



____________________________________ (your City, State Zip)


I understand and agree to ALL the following conditions of sale:


As the purchaser of cold laser components sold by Laser-Therapy.US, 56 Woodland Drive, Woodland Park, NJ 07424 I certify I will only use the equipment on animals I own. I understand the equipment is not returnable for credit or refund. I understand the equipment is fully warranted for one year (except accidental or intentional abuse).



____________________________________ (your signature)


____________________________________ (date)