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	Convaid EZ12 EZ 900860-903465 Rider 10 Degree Fixed Tilt Special Needs Stroller - Purple SKU: 900860-903465 Out of Stock		$1,418.40	$1,418.40

1	Convaid CX12 902845-903855 Cruiser Cordura 30 Degree Fixed Tilt Wheelchair - True Red SKU: 902845-903855 Out of Stock		$1,876.00	$1,876.00

1	Edushape 806050 Edu Blocks SKU: 806050 In Stock - Ships within 24 hours		$162.00	$162.00

1	Flexible Flyer 648 Winter Lightning Sled - Green SKU: 648GREEN In Stock - Ships within 24 hours		$49.99	$49.99

1	Detecto DR-400C Visiting Nurse Scale 400 lb x 0.5 lb with Portable Height Rod and Case for Both SKU: DR-400CKT In Stock - Ships within 24 hours		$480.43	$480.43

1	Peg Perego IGOR0055 Case IH Magnum Tractor with Trailer SKU: IGOR0055 Out of Stock		$339.00	$339.00

1	Peg Perego - Siesta High Chair Ice SKU: SIESTAICE Out of Stock		$329.99	$329.99

1	CardioCheck Total Cholesterol Test Strips, 25 ct /item id 1711 SKU: BIO-TC-25 In Stock - Ships within 24 hours		$109.95	$109.95

1	Rice Lake 260-10-1 Bariatric Handrail Scale 800 x 0.2 lb SKU: 170139 In Stock - Ships within 24 hours		$1,191.40	$1,191.40

1	Edushape 709052 Corrugated Blocks SKU: 709052 In Stock - Ships within 24 hours		$40.50	$40.50

		Truck Shipping	$306.23	$306.23


			Total	$6,303.89