Home / Order

Perimed accessories

Here you can get a quote or order our fixation ring kits, contact liquid, membrane kits, and double-sided strip tape.

Order or request quote

This form is for customers in the US and Canada

"*" indicates required fields

Instagram

This field is for validation purposes and should be left unchanged.

Quote or order?*

I want to order

I want a quote

Contact details

Name (order contact person)*

First Last

Email (order contact person)*

Telephone number (order contact person)*

Delivery details

Delivery to hospital / clinic*

Delivery department*

Delivery country*

Delivery State*

Delivery Province / Territory*

Delivery street address*

Delivery city*

Delivery zip*

For customers outside the US and Canada, please visit our international site.

Billing information

Contact person for billing*

First Last

Email (billing)*

Billing phone

Billing organization name*

Billing department*

Is your organization tax-exempt?*

Yes

Billing address*

Billing city*

Billing zip*

Billing country*

Billing State*

Billing Province / Territory*

Order/quote details

What would you like to order/receive a quote for?*

Fixation ring kits (rings and contact liquid)

Contact liquid only

Membrane kits

Double-sided tape strips

Quantity — fixation ring kits*

Each kit contains 50 fixation rings and 1 (20mL) bottle of contact liquid.

Quantity — contact liquid*

Contact liquid comes in bottles of 20 mL

Quantity — membrane kit*

Each kit contains 12 membranes

Quantity — double-sided tape strips*

Each pack contains 100 strips

Purchase order number/identification

Instrument?*

What instrument are you using?

Optional message

Include any additional billing or delivery information that is not included above. If, for example, you wish to order more than 100 kits (5000 rings), please add that information here.

Data consent

Perimed's Privacy Policy

I have read and agree to Perimed's Privacy Policy*

Yes