HealthCheckSystems

Billing Address
(As shown on your credit card statement.)
First name * Last name * Company Name Address * Address2 City State\Province: * Zip/Postal Code * Country * Day Phone * Cell Phone Fax Email *
Shipping Address
First name * Last name * Company Name Address * Address2 City * State\Province * Zip/Postal Code * Country * Day Phone * Cell Phone Fax
Payment Info
Name on card * Credit Card number * CVV *

Month *(12) Year*(2025)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	Detecto BRW-1000 Portable Wheelchair Bariatric Scale 32 in x 40 in - 1000 lb x 0.2 lb SKU: BRW-1000 In Stock - Ships within 24 hours		$2,466.89	$2,466.89

1	Detecto Dr550C-Case SKU: DR550C-Case In Stock - Ships within 24 hours		$66.34	$66.34

		Truck Shipping	$304.00	$304.00


			Total	$2,837.23