Wholesale Order Request

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After you fill out this order request, we will contact you to go over details and availability before the order is completed. If you would like faster service and direct information on current stock and pricing please contact us at Contact us at +66(98) 8080905 or andres@recharge.health

Email *

What items would you like to order? *

Flex Beam Charcoal Grey w/accesories

Flex Beam Pearl White w/accesories

Required

Name and Surname

Company Name *

Phone number *

Include country and area code

Address (for Billing purpose) *

Include office or house number, street, city, state or province, country and zip code

Shipping Address (if different than above) *

Include office or house number, street, city, state or province, country and zip code

Contact Person for shipping purpose

Include full name, email and phone number

Preferred Payment Method *

NOTE: 100% upfront payment (it can be split into 2 payments for more than 20 units)

Wire or Electronic Transfer (preferred)

Credit Card (3% additional fee)

Other:

Required

Currency of Payment *

USD

GBP

EUR

AUD

CAD

THB

Required

Shipping Preference

Express Air (7-10 days)

Air International Economy (10-20 days)

Sea freight (only available for more than 100 units and depending on destination port)

Other:

Clear selection

Shipping Term *

Exworks (EXW) - shipping cost, import duties and taxes are EXCLUDED

Delivered at Place (DAP) - shipping cost included, Import duties and VAT are EXCLUDED

Delivered Duty Paid (DDP) - shipping cost and import duties/taxes are INCLUDED

CIP/CIF - only for more than 100 units

Other:

Questions and comments

A copy of your responses will be emailed to the address you provided.

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