Order Form

Please use this form to submit your order.
Or order toll-free at 1- 800- 463- 5470.

Name:

 
Address:

City:

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Phone:
(with area code)

Fax:
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Products Requested:

Exerlopers: Qty.: @ US$199.00
Insta-Pulse 105: Qty.: @ US$159.00
Insta-Pulse 107: Qty.: @ US$149.00
Insta-Pulse Wall Model 201: Qty.: @ US$349.00
Insta-Pulse Floor Model 203: Qty.: @ US$399.00
Antense: Qty.: @ US$179.00
Insta-Runner: Qty.: @ US$499.00
Body-Trim: Qty.: @ US$69.00
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Expiration Date: Month: Year:
For a blank printable fax/mail order form click here.

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To speak to our friendly representatives or to place an order call our toll-free number.

1-800-463-5470
DEALERS & OEM ENQUIRIES WELCOME

Tel.: (514) 637-0016 - Fax: (514) 637-1353 - Email: biosig@biosig.net
P.O. Box 860, Champlain, NY 12919

Products on the Exerlopers web site are patented. Please be aware of patent infringers. It is illegal to sell or use patent infringed products.


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