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PRE ORDER FORM

After you fill out the information below, you will be sent a DocuSign Order Form to add payment method and Complete your Order. Your order is charged & shipped directly by the manufacturer distribution center assigned to the destination country. All your data is private and we do not share with any third party.

3 Promo Options Drop Down Select 1

Prime Add-Ons Select 1 or Multiple For Option 1 & 2 (Some ADD-ONS already included)

Exagon Spot Applicator USD 665.00 CAD $907.00 (EU & Rest of the World please call for pricing in DocuSign Order Form) Exagon Pad Applicator USD 511.00 CAD $733.00 (EU & Rest of the World please call for pricing in DocuSign Order Form) iMRS Prime Organizer Control & Exagon Applicator Travel Bag USD $109.00 CAD $134.00 (EU & Rest of the World pricing in DocuSign Order Form) Exagon Brain USD $951.00 CAD $1265.00 (EU & Rest of the World pricing in DocuSign Order Form) Exagon Sense USD $951.00 CAD $1388.00 (EU & Rest of the World pricing in DocuSign Order Form)

OMNIUM1 Add-Ons Select 1 or Multiple For Option 3 (Some ADD-ONS already included)

OmniSpot Applicator USD 687.00 CAD $887.00 (EU & Rest of the World please call for pricing in DocuSign Order Form) OmniPad Applicator USD 461.00 CAD $602.00 (EU & Rest of the World please call for pricing in DocuSign Order Form) OmniBag Travel Bag USD $49.00 CAD $56.00 (EU & Rest of the World pricing in DocuSign Order Form) OmniBrain USD $687.00 CAD $887.00 (EU & Rest of the World pricing in DocuSign Order Form) 3 in 1 Adapter USD $214.00 CAD $278.00 (EU & Rest of the World pricing in DocuSign Order Form)

Please include Additional add-on not listed above or Request (Prime & Omnium1 Add-Ons are not compatible)

PRE ORDER FORM

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