Order Form

Please fill out the information and click submit. Or fill out, print and fax to (210) 614-2080. If you have any questions, please contact us.
• If you are an existing client, the order will be processed within 24 hours according to our existing contract.
• If you are a new client, you will be contacted to review your order and to give you our cost saving price quotes.


*Required fields

 
Business Name*   
Contact's First Name*   
Contact's Last Name*   
Street Address   
City   
State/Province   
Zip Code/Postal Code   
Country   
Phone Number*   
  Ext.  
e.g. 555-555-5555
E-mail Address   

All products (trays and needles) come in cases of ten.
Tray Kits

Kit # PPI-01 Multiple Sympathethic Block Tray Qty
Kit # PPI-02 Multi-Purpose Nerve Block Tray Qty
Kit # PPI-03 18 GA. x 3.5" Epidural Tray Qty
Kit # PPI-04 20 GA. x 3.5" Single Shot Epidural Tray Qty
Kit # PPI-09 Facet Injection Tray Qty
Kit # PPI-40 Universal Tray Qty
Kit # PPI-44 Facet Injection Tray Qty
Kit # PPI-45 Universal Block Tray Qty
Custom Tray Request Form  

Needles

* most popular needles
Spinal Needles
Quinke Type Point
Plastic Hub, CM Calibrations, Depth Guide
Needle # RMPS1806 18 GA. x 6" Qty
Needle # RMPS2006 20 Ga. x 6" Qty
Needle # RMPS2206* 22 GA. x 6.0" Spinal Qty
Needle # RMPS2208* 22 GA. x 8.0" Spinal Qty
Needle # RMPS1803 18 GA. x 3.5" Qty
Needle # RMPS2002 20 GA. x 2.0" Qty
Needle # RMPS2003 20 GA. x 3.5" Qty
Needle # RMPS2203 22 GA. x 3.5" Qty
Needle # RMPS23025 23 GA. x 2.5" Qty
Needle # RMPS2303 23 GA. x 3.5" Qty
Plastic Hub, CM Calibrations
Needle # RMPS2506 25 GA. x 6" Qty
Needle # RMPS2508 25 GA. x 8" Qty
Needle # RMPS2503 25 GA. x 3.5" Qty
Plastic or Metal Hub Spinal Needles
Needle # P8-1149-18P 18 GA. x 8" Qty
Needle # P8-1149-25P 25 GA. x 8" Qty
Needle # P10-1149-18P 18 GA. x 10" Qty
Needle # P10-1149-20P 20 GA. x 10" Qty
Needle # P10-1149-22P 22 GA. x 10" Qty
Metal Hub, CM Calibrations
Needle # RMMS18047 18 GA. x 4.75" Qty
Needle # RMMS18055 18 GA. x 5.5" Qty
Needle # RMMS20055 20 GA. x 5.5" Qty
Gertie Marx™
Spinal Needles for Regional Anesthesia
Needle # GM2290 22 GA. x 3.5" Qty
Needle # GM2490 24 GA. x 3.5" Qty
Needle # GM2690 26 GA. x 3.5" Qty
Spinal Needles for Regional Anesthesia Including Introducer
Needle # GM2290-I 22 GA. x 3.5" Qty
Needle # GM2490-I 24 GA. x 3.5" Qty
Needle # GM2690-I 26 GA. x 3.5" Qty
Whitacre Point Spinal Needles
Needle # RPPN2235 22 GA. x 3.5" Qty
Needle # RPPN2735I
(with introducer)
27 GA. x 3.5" Qty
Needle # RPPN2747 27 GA. x 4.75" Qty
Needle # RPPN2750 27 GA. x 5.0" Qty
Sprotte Spinal Needles
For Use in Regional Anesthesia Blocks
(Ideal for obese patients)
Needle # S2190 21 GA. x 3.5" Qty
Needle # S2290 22 GA. x 3.5" Qty
Needle # S2490 24 GA. x 3.5" Qty
Needle # S20120 20 GA. x 4.75" Qty
Needle # S22120 22 GA. x 4.75" Qty
Needle # S20150 20 GA. x 6.0" Qty
Needle # S22150 22 GA. x 6.0" Qty
With Introducer
Needle # INS2490 24 GA. x 3.5" Qty
Needle # INS2590 25 GA. x 3.5" Qty
Needle # INS24120 24 GA. x 4.75" Qty
Needle # INS25120 25 GA. x 4.75" Qty
Needle # INS24150 24 GA. x 6.0" Qty
Chiba Style Spinal Needles
Echogenic Tip, CM Markings, Sliding Depth Guide
Needle # CN2009UG 20 GA. x 3.5" Qty
Needle # CN2209UG* 22 GA. x 3.5" Chiba Qty
Needle # CN2015UG 20 GA.x 6.0" Qty
Needle # CN2020UG 20 GA. x 8.0" Qty
Needle # CN2220UG 22 GA. x 8.0" Qty
CM Calibrations
Needle # MCN2206* 22 GA. x 6.0" Chiba Qty
Reganes™ Chiba Needles
CM Calibrations, Depth Guide, Etched Tip
Needle # RMCN2006 20 GA. x 6.0" Qty
Needle # RMCN2206 22 GA. x 6.0" Qty
Needle # RMCN2208* 22 GA. x 8.0" Chiba Qty
Epidural Needles
Tuohy
Metal Hub, Depth Markers
Needle # RM1730X 17 GA. x 3.0" Qty
Needle # RM1735D 17 GA. x 3.5" Qty
Metal Hub
Needle # RM1435A 14 GA. x 3.5" Qty
Needle # RM2025A 20 GA. x 2.5" Qty
Plastic Hub, Removable Wing, Depth Markers
Needle # RP1705RW 17 GA. x 5.0" Qty
Needle # RP1805RW 18 GA. x 5.0" Qty
Needle # RP2005RW 20 GA. x 5.0" Qty
Plastic Hub, Fixed Wing, Depth Markers
Needle # RP1706A 17 GA. x 6.0" Qty
Needle # RP1806A 18 GA. x 6.0" Qty
Metal Hub, Depth Markers
Needle # RM1705A 17 GA. x 5.0" Qty
Plastic Hub, Metal Stylet, Depth Markers
Needle # RP1735MRW 17 GA. x 3.5" Qty
Needle # RP1835MRW 18 GA. x 3.5" Qty
Needle # RP2035RW* 22 GA. x 3.5" Epidural Qty
Needle # RP1635D 16 GA. x 3.5" Qty
Needle # RP1702D 17 GA. x 2.0" Qty
Needle # RP1735D 17 GA. x 3.5" Qty
Needle # RP1802D 18 GA. x 2.0" Qty
Needle # RP1835D 18 GA. x 3.5" Qty
Needle # RP2035W* 20 GA. x 3.5" Epidural Qty
Needle # RP2235RW 22 GA. x 3.5" Qty
Plastic Hub, Plastic Stylet, Depth Markers
Needle # RP1735RW 17 GA. x 3.5" Qty
Needle # RP1835RW* 18 GA. x 3.5" Epidural Qty
Needle # RP1735P 17 GA. x 3.5" Qty
Needle # RP1835P 18 GA. x 3.5" Qty
Alderete Epidural Needles
Plastic Hub, Removable Wing, Depth Markers with Introducer
Needle # RP2503RWUS 25 GA. x 3.0" Qty
Hustead Epidural Needles
Plastic Hub/Stylet, Removable Wing, Depth Markers
Needle # RP1735BPR 17 GA. x 3.5" Qty
Needle # RP1835BPR 18 GA. x 3.5" Qty

Phone: Toll Free- 1-800-359-5756 or (210) 614-2062
Fax: (210) 614-2080
 
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