{"id":4102,"date":"2025-12-18T07:50:47","date_gmt":"2025-12-18T07:50:47","guid":{"rendered":"https:\/\/www.perimed-instruments.com\/us\/?page_id=4102"},"modified":"2026-02-03T09:51:03","modified_gmt":"2026-02-03T09:51:03","slug":"order","status":"publish","type":"page","link":"https:\/\/www.perimed-instruments.com\/us\/order\/","title":{"rendered":"Order"},"content":{"rendered":"<section class=\"relative w-full mx-auto pt-24 2xl:pt-24 pb-24 2xl:pb-24 none\">\n                    <div class=\"sec-bg-color absolute top-0 inset-0 flex justify-center overflow-hidden w-full h-full pointer-events-none z-[-2]\"  style=\"background-color:#adcbff;\">\n            <\/div>\n                                                \n                                        <div class=\"sec-bg sec-bg-laptop absolute top-0 inset-0 flex justify-center overflow-hidden bg-no-repeat w-full h-full pointer-events-none z-[-1]\" style=\"background-image: url(https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/2024\/11\/background-hero-white-blur-copy.webp);background-size:cover;background-position:center;\"><\/div>\n                                        <div class=\"sec-bg sec-bg-mobile absolute top-0 inset-0 flex justify-center overflow-hidden bg-no-repeat w-full h-full pointer-events-none z-[-1]\" style=\"background-image: url(https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/2024\/11\/background-hero-white-blur-copy.webp);background-size:cover;background-position:center;\"><\/div>\n                                        <div class=\"sec-bg sec-bg-wide absolute top-0 inset-0 flex justify-center overflow-hidden bg-no-repeat w-full h-full pointer-events-none z-[-1]\" style=\"background-image: url(https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/2024\/11\/background-hero-white-blur-copy.webp);background-size:cover;background-position:center;\"><\/div>\n                                        \n\n        <div class=\"section__content  max-w-screen-xl px-4 mx-auto sec_no_tabs\" >\n            \n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-group is-content-justification-left is-layout-constrained wp-container-core-group-is-layout-4d085cea wp-block-group-is-layout-constrained\"><div class=\"yoast-breadcrumbs\"><span><span><a href=\"https:\/\/www.perimed-instruments.com\/us\/\">Home<\/a><\/span> \/ <span class=\"breadcrumb_last\" aria-current=\"page\">Order<\/span><\/span><\/div>\n\n\n<h1 class=\"wp-block-heading pb-8 has-h-1-font-size\" id=\"h-perimed-accessories\">Perimed accessories<\/h1>\n\n\n\n<p class=\"has-text-hero-font-size\">Here you can get a quote or order our fixation ring kits, contact liquid, membrane kits, and double-sided strip tape.<\/p>\n\n\n\n<p class=\"has-p-small-font-size\"><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"#order-form\">Order or request quote<\/a><\/div>\n<\/div>\n\n\n<div class=\"gn-spacer-block pb-12\">\n    <\/div>\n\n\n\n<p class=\"has-p-small-font-size\">This form is for customers in the US and Canada<\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image alignright size-large is-style-rounded\"><img decoding=\"async\" src=\"https:\/\/www.perimed-instruments.com\/wp-content\/uploads\/Perimed-fixation-rings-fluid-packaging-copy-1024x768.webp\" alt=\"\" class=\"wp-image-4500\"\/><\/figure>\n<\/div>\n<\/div>\n\n\n        <\/div>\n    <\/section>\n\n\n<section class=\"relative w-full mx-auto pt-20 pb-20 none\" id=\"order-form\">\n                        \n\n        <div class=\"section__content  max-w-screen-xl px-4 mx-auto sec_no_tabs\" >\n            \n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\"><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\"><div class=\"gn-spacer-block pb-12\">\n    <\/div>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_3' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/us\/wp-json\/wp\/v2\/pages\/4102#gf_3' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_3_87\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_87'>Phone<\/label><div class='gfield_description' id='gfield_description_3_87'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_87' id='input_3_87' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_3_62\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><style>\n\/* Billing Information section background *\/\n.contact-information {\n    background-color: #e0f7fa;  \/* soft light blue *\/\n    padding: 20px;\n    border-radius: 8px;\n    margin-bottom: 20px;\n}\n\n\/* Optional: make labels stand out *\/\n.billing-information .gfield_label {\n    font-weight: bold;\n    color: #00796b;\n}\n<\/style><\/div><fieldset id=\"field_3_67\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Quote or order?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_67'>\n\t\t\t<div class='gchoice gchoice_3_67_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Order'  id='choice_3_67_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_67_0' id='label_3_67_0' class='gform-field-label gform-field-label--type-inline'>I want to order<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_67_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Quote'  id='choice_3_67_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_67_1' id='label_3_67_1' class='gform-field-label gform-field-label--type-inline'>I want a quote<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_37\" class=\"gfield gfield--type-section gfield--input-type-section gsection contact-information field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Contact details<\/h3><\/div><fieldset id=\"field_3_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name (order contact person)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_5'>\n                            \n                            <span id='input_3_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_3_5_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_5.3' id='input_3_5_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_3_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_3_5_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_5.6' id='input_3_5_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_3_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_7'>Email (order contact person)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_3_7' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_3_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_6'>Telephone number (order contact person)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_3_6' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_3_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Delivery details<\/h3><\/div><div id=\"field_3_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_29'>Delivery to  hospital \/ clinic<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_3_29' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_19'>Delivery department<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_3_19' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_54\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_54'>Delivery country<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_3_54' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='USA' >USA<\/option><option value='Canada' >Canada<\/option><\/select><\/div><\/div><div id=\"field_3_72\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_72'>Delivery State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_72' id='input_3_72' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><\/select><\/div><\/div><div id=\"field_3_73\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_73'>Delivery Province \/ Territory<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_73' id='input_3_73' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' >British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select><\/div><\/div><div id=\"field_3_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_51'>Delivery street address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_3_51' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_49'>Delivery city<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_3_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_50'>Delivery zip<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_3_50' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_68\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>For customers outside the US and Canada, \n<a href=\"https:\/\/perimed-instruments.com\/order\" target=\"_blank\">please visit our international site<\/a>.<\/p><\/div><div id=\"field_3_64\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><style>\n\/* Billing Information section background *\/\n.billing-information {\n    background-color: #f0f4c3;  \/* soft light blue *\/\n    padding: 20px;\n    border-radius: 8px;\n    margin-bottom: 20px;\n}\n\n\/* Optional: make labels stand out *\/\n.billing-information .gfield_label {\n    font-weight: bold;\n    color: #00796b;\n}\n<\/style><\/div><div id=\"field_3_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection billing-information field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Billing information<\/h3><\/div><fieldset id=\"field_3_21\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Contact person for billing<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_21'>\n                            \n                            <span id='input_3_21_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_3_21_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_21.3' id='input_3_21_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_3_21_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_3_21_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_21.6' id='input_3_21_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_3_22\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_22'>Email (billing)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_22' id='input_3_22' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_61\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_61'>Billing phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_61' id='input_3_61' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_33'>Billing organization name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_3_33' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_20'>Billing department<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_3_20' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is your organization tax-exempt?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_77'>\n\t\t\t<div class='gchoice gchoice_3_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_3_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_77_0' id='label_3_77_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_3_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_77_1' id='label_3_77_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_55\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_55'>Billing address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_3_55' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_56'>Billing city<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_3_56' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_57\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_57'>Billing zip<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_3_57' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_58\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_58'>Billing country<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_3_58' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='Canada' >Canada<\/option><option value='United States' >United States<\/option><\/select><\/div><\/div><div id=\"field_3_74\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_74'>Billing State<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_74' id='input_3_74' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><\/select><\/div><\/div><div id=\"field_3_75\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_75'>Billing Province \/ Territory<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_75' id='input_3_75' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211;<\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' >British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select><\/div><\/div><div id=\"field_3_65\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><style>\n\/* <Order Information section background *\/\n.order-information {\n    background-color: #ffe0b2;  \/* soft light blue *\/\n    padding: 20px;\n    border-radius: 8px;\n    margin-bottom: 20px;\n}\n\n\/* Optional: make labels stand out *\/\n.billing-information .gfield_label {\n    font-weight: bold;\n    color: #00796b;\n}\n<\/style><\/div><div id=\"field_3_40\" class=\"gfield gfield--type-section gfield--input-type-section gsection order-information field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Order\/quote details<\/h3><\/div><fieldset id=\"field_3_78\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What would you like to order\/receive a quote for?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_78'><div class='gchoice gchoice_3_78_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.1' type='checkbox'  value='Fixation ring kits (rings and contact liquid)'  id='choice_3_78_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_78_1' id='label_3_78_1' class='gform-field-label gform-field-label--type-inline'>Fixation ring kits (rings and contact liquid)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_78_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.2' type='checkbox'  value='Contact liquid only'  id='choice_3_78_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_78_2' id='label_3_78_2' class='gform-field-label gform-field-label--type-inline'>Contact liquid only<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_78_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.3' type='checkbox'  value='Membrane kits'  id='choice_3_78_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_78_3' id='label_3_78_3' class='gform-field-label gform-field-label--type-inline'>Membrane kits<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_78_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_78.4' type='checkbox'  value='Double-sided tape strips'  id='choice_3_78_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_78_4' id='label_3_78_4' class='gform-field-label gform-field-label--type-inline'>Double-sided tape strips<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_83\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><img decoding=\"async\" src=\"https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/fixation-rings-fluid-packaging-1.webp\" alt=\"TcpO2 fixation rings\" style=\"max-width:50%; height:auto; border-radius:12px;\">\n<\/div><div id=\"field_3_63\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_63'>Quantity \u2014 fixation ring kits<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_63'>Each kit contains 50 fixation rings and 1 (20mL) bottle of contact liquid. <\/div><div class='ginput_container ginput_container_select'><select name='input_63' id='input_3_63' class='small gfield_select'  aria-describedby=\"gfield_description_3_63\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-<\/option><option value='1 \u2014 50 rings' >1 \u2014 50 rings<\/option><option value='2 \u2014 100 rings' >2 \u2014 100 rings<\/option><option value='3 \u2014 150 rings' >3 \u2014 150 rings<\/option><option value='4 \u2014 200 rings' >4 \u2014 200 rings<\/option><option value='5 \u2014 250 rings' >5 \u2014 250 rings<\/option><option value='10 \u2014 500 rings' >10 \u2014 500 rings<\/option><option value='25 \u2014 1 250 rings' >25 \u2014 1 250 rings<\/option><option value='50 \u2014 2 500 rings' >50 \u2014 2 500 rings<\/option><option value='100 \u2014 5 000 rings' >100 \u2014 5 000 rings<\/option><\/select><\/div><\/div><div id=\"field_3_84\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><img decoding=\"async\" src=\"https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/Perimed-contact-liquid-TC560.webp\" alt=\"TcpO2 contact liquid\" style=\"max-width:20%; height:auto; border-radius:12px;\">\n<\/div><div id=\"field_3_79\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_79'>Quantity \u2014 contact liquid<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_79'>Contact liquid comes in bottles of 20 mL<\/div><div class='ginput_container ginput_container_select'><select name='input_79' id='input_3_79' class='small gfield_select'  aria-describedby=\"gfield_description_3_79\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-<\/option><option value='1 \u2014 bottle' >1 \u2014 bottle<\/option><option value='2 \u2014 bottles' >2 \u2014 bottles<\/option><option value='3 \u2014 bottles' >3 \u2014 bottles<\/option><option value='4 \u2014 bottles' >4 \u2014 bottles<\/option><option value='5 \u2014 bottles' >5 \u2014 bottles<\/option><\/select><\/div><\/div><div id=\"field_3_85\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><img decoding=\"async\" src=\"https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/Radiometer-904-308-membrane-copy-2-scaled.webp\" alt=\"Membrane kits from Radiometer\" style=\"max-width:50%; height:auto; border-radius:12px;\">\n<\/div><div id=\"field_3_80\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_80'>Quantity \u2014 membrane kit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_80'>Each kit contains 12 membranes<\/div><div class='ginput_container ginput_container_select'><select name='input_80' id='input_3_80' class='small gfield_select'  aria-describedby=\"gfield_description_3_80\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-<\/option><option value='1 kit' >1 kit<\/option><option value='2 kits' >2 kits<\/option><option value='3 kits' >3 kits<\/option><option value='4 kits' >4 kits<\/option><option value='5 kits' >5 kits<\/option><\/select><\/div><\/div><div id=\"field_3_86\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><img decoding=\"async\" src=\"https:\/\/www.perimed-instruments.com\/us\/wp-content\/uploads\/sites\/3\/PF-105-3-strip-tape-copy.webp\" alt=\"Tape strips\" style=\"max-width:50%; height:auto; border-radius:12px;\">\n<\/div><div id=\"field_3_81\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_81'>Quantity \u2014 double-sided tape strips<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_81'>Each pack contains 100 strips<\/div><div class='ginput_container ginput_container_select'><select name='input_81' id='input_3_81' class='small gfield_select'  aria-describedby=\"gfield_description_3_81\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-<\/option><option value='1 pack \u2014 100 strips' >1 pack \u2014 100 strips<\/option><option value='2 packs \u2014 200 strips' >2 packs \u2014 200 strips<\/option><option value='3 packs \u2014 300 strips' >3 packs \u2014 300 strips<\/option><option value='4 packs \u2014 400 strips' >4 packs \u2014 400 strips<\/option><option value='5 packs \u2014 500 strips' >5 packs \u2014 500 strips<\/option><\/select><\/div><\/div><div id=\"field_3_42\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_42'>Purchase order number\/identification<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_3_42' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_70\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_70'>Instrument?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_70'>What instrument are you using?<\/div><div class='ginput_container ginput_container_select'><select name='input_70' id='input_3_70' class='medium gfield_select'  aria-describedby=\"gfield_description_3_70\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>-<\/option><option value='PeriFlux 6000' >PeriFlux 6000<\/option><option value='PeriFlux 5000' >PeriFlux 5000<\/option><option value='TCM (Radiometer)' >TCM (Radiometer)<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_3_36\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_36'>Optional message<\/label><div class='gfield_description' id='gfield_description_3_36'>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.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_3_36' class='textarea small'  aria-describedby=\"gfield_description_3_36\" maxlength='1000'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_43\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Data consent<\/h3><\/div><div id=\"field_3_45\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><a href=\"https:\/\/www.perimed-instruments.com\/us\/about\/governance\/privacy-policy\/\">Perimed's Privacy Policy<\/a>\n\n<\/div><fieldset id=\"field_3_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read and agree to Perimed&#039;s Privacy Policy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_44'><div class='gchoice gchoice_3_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='Yes'  id='choice_3_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_1' id='label_3_44_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_3' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <input type='hidden' class='gform_hidden' name='gform_submission_speeds' value='{&quot;pages&quot;:[]}' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_3' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_3' id='gform_theme_3' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_3' id='gform_style_settings_3' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_3' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='3' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='SEK' value='2ZbA25u58x1IKfAUZIYYBP87SFArl0iPhP+u2MML+5weYQruIHg18rjLrk6dzEApUXJ4vixWG\/vyfPbTaTrxLCaAfXi+1FZmEfEllE8MNC2GoPg=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_3' 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