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Hyperboloid Order Form
Each pack of 10 is $25 plus s/h
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Email
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First Name
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Last Name
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Mailing Address ( Street)
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Mailing Address (City, State, Zip Code)
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email address
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Phone #
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Please select a size and quantity. Each packet has 10 hyperboloids/packet
1
2
3
4
5
Other
P (children, adolescents)
PP (Small children aged 4-10 years)
M (Medium, for teenagers, used in adults)
G (Big teeth and wide dental arch)
GG (increase mouth opening gradual exercises
multi-pack
1
2
3
4
5
Other
P (children, adolescents)
PP (Small children aged 4-10 years)
M (Medium, for teenagers, used in adults)
G (Big teeth and wide dental arch)
GG (increase mouth opening gradual exercises
multi-pack
If you selected other, please specify size and quantity below
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How did you find us?
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Once you have submitted this form, a confirmation will be generated. An email with your invoice will be sent. If you have any questions, please send an email to
info@freedompt.com
including your name.
Please note, shipment of product will occur after payment completion.
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