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Order SomTabs – Canada

SomTabs Order Form - Canada

Order Size
- 3 Month Supply
- 6 Month Supply
- 12 Month Supply
Standard Shipping
$ 12.95 CAD
Coupon
Total
$ 0.00 CAD
Name*
First Last
Email*
Phone*
Billing Address - Canada Residents Only,*
Street Address Address Line 2 City Province Postal Code

Shipping only available for Canada residents, unavailable for shipment to PO Boxes
Is billing address is the same as shipping address?
- Yes shipping address is the same as billing address.
Shipping Address - US and Canada Residents Only, Unavailable for shipment to PO Boxes*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
- Yes, I would like to receive information and special offers from SomnoMed.
Device serial number
Devices serial number is located next to the SomnoMed logo printed on the device. It is important to register your device for warranty purposes.
Total
$ 0.00 CAD
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Comments
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