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TheraTogs - Order Form
Please fill out the form below to order a TheraTogs or a Wunzi suit.
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TheraTogs Order Form for
ABR-DENMARK.COM
Name
*
for invoice
Your answer
Address
*
for invoice / shipping address
Your answer
Contact address
if different than above / shipping address
Your answer
Order other related ABR Denmark services:
*
Pretrial - before decision to purchase - at our locations only
Adjustment
Fitting and one adjustment consultation ( 30 min.) over 10 month period - location or online
Other:
Required
TheraTogs suit being ordered:
*
#110 TheraTogs (PTA): Infant kr3.256,00
#110P PLUS (ABR SET - Two Full Suits) Infant kr4.440,00
#210 TheraTogs (PTA): Pre-School kr3.922,00
#210P TheraTogs (PTA): Pre-School PLUS (ABR SET- Two Full Suits) kr5.624,00
#310 TheraTogs (PTA): Pediatric kr4.070,00
#310P TheraTogs (PTA): Pediatric PLUS (ABR SET- Two Full Suits) kr7.178,00
#410 TheraTogs (PTA): Petite Adult kr5.032,00
#410P TheraTogs (PTA): Petite Adult PLUS (ABR SET - Two Full Suits) kr9.768,00
Wunzi System: XX Small kr2.500,00
Wunzi System: X Small kr2.500,00
Wunzi System: Small kr2.500,00
Wunzi System: Medium kr2.500,00
Wunzi System: Large kr2.500,00
no order - PRE-TRIAL ONLY
TheraTogs Fitting and one adjustment session kr2.500,00
Other:
Required
Where invoice should be sent to
*
e-mail
Your answer
Contact email address
if different than above
Your answer
Child's name / client name
*
Your answer
Telephone number
with country code
Your answer
Other relevant information - (EAN nr, caseworker name)
Your answer
Who submitted the form
*
Your answer
Important: Please double check whether all information is correct.
Clients are responsible for updating their contact and invoice information. Thank you for your cooperation.
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