Brochure Holder - Lumenis Aesthetic

Not Included in Package
(Order Separately)
Before & After Slides
PB P00 0064 Rev. B
Hair Removal
Patient Brochures
(pack of 50)
PB P00 0003 Rev. B
Before & After Patient Brochures
(pack of 50)
PB P00 0005 Rev. B
Before & After
Patient Education Guide (XLG-Size)
PB 000 0062 Rev. B
Before & After Slides
PB 000 0111 Rev. B
Before & After Slides
PB 000 0111 Rev. B
35mm Patient Slide
Presentation & Script
PB P00 0064 Rev. B
Plexi Stand (3)
Brochure Holder
PB 000 0042
Veins Patient Brochures
(pack of 50)
PB P00 0004 Rev. B
Kit Number KT 900 0020 Rev.B
Patient Video Loop (PAL)
PB 000 0133 Rev. B
Printed
Marketing Guide
PB 000 0114 Rev. B
Physician Referral Service Registration Form
(Free on-line service. Available in the U.S. and Canada only.)
PB 000 0076 Rev. C
Marketing Guide on
CD-Rom with Digital
Files for Ad Slicks
PB 000 0113 Rev. B
35mm Patient Slide
Presentation & Script
PB 000 0111 Rev. B
35mm Patient Slide Presentation & Script
MultiApplication
PB 000 0111 Rev. B
Before & After
Poster
PB 000 0101 Rev. B
Clinical Casebook
PB P00 0119 Rev. B
Veins Patient Education Guide
PB 000 0017 Rev. B
Patient Video Loop (VHS)
PB 000 0118 Rev. B
Patient Marketing Guide
and CD Rom in Plastic Carrier
PB P00 0112 Rev. B
Before & After Counter Display - MultiApplication
PB 000 0137 Rev. B
Before & After Counter Display - Leg Veins
PB 000 0138 Rev. B
Before & After Counter Display
PB 000 0097 Rev. B
Before & After Counter Display
PB P00 0075 Rev. B
Before & After
Veins Poster
PB 000 0115 Rev. B
Before & After - Poster
PB 000 0116 Rev. B
Before & After Poster
PB P00 0074 Rev. B
Patient Postcards
MultiApplication
(pack of 50)
PB 000 0123 Rev. B
Patient Postcards
Advertisement A
(pack of 50)
PB 000 0098 Rev. B
Counter Display - MultiApplication
PB 000 0121 Rev. B
Counter Display - Leg Veins
PB 000 0120 Rev. B
Counter Display A
PB 000 0095 Rev. B
Counter Display A
PB P00 0067 Rev. B
Patient Postcards
Leg Veins
(pack of 50)
PB 000 0122 Rev. B
Patient Postcards
Advertisement A
(pack of 50)
PB 000 0065 Rev. B

MATERIALS ORDER FORM
Name: Customer No. (8 digit #):
Shipping Address:
City: State: Zip: Country:
Tel:
Fax: e-mail address:
Upon receipt of this
fax, a customer
support representative
will call you back
with a confirmation
number and an estimated
time of arrival
for your order.
Page 1 of 2
IPL & Laser for all your skin care needs
Part Unit Qty. Total
Number Price Price
Building Blocks Kit - MultiApplications KT 900 0020 Rev. B $ 3000.00
“How-To” Guide and CD-ROM PB 000 0112 Rev. B $ 750.00
“How-To” Guide - MultiApplication PB 000 0114 Rev. B $ 250.00
CD-ROM MultiApplication PB 000 0113 Rev. B $ 500.00
Poster Veins - Before and After PB 000 0115 Rev. B $ 20.00
Poster MultiApplications - Before and After PB 000 0116 Rev. B $ 20.00
Counter Display - Leg Veins PB 000 0120 Rev. B $ 10.00
Counter Display - Leg Veins - Before and After PB 000 0138 Rev. B $ 10.00
Counter Display - MultiAp. - Before and After PB 000 0137 Rev. B $ 10.00
Counter Display - MultiApplications PB 000 0121 Rev. B $ 10.00
Vein Patient Brochure (Package of 50) PB P00 0004 Rev. B $ 35.00
Patient Video - VHS Loop PB 000 0118 Rev. B $ 25.00
Patient Video - PAL Loop (Not in Kit) PB 000 0133 Rev. B $ 25.00
Patient Postcards - Leg Veins (Package of 50) PB 000 0122 Rev. B $ 25.00
Patient Postcards - MultiApplications (Package of 50) PB 000 0123 Rev. B $ 25.00
Patient Slide Presentation and Script - MultiAp. PB 000 0111 Rev. B $ 350.00
Clinical Casebook - MultiApplication PB 000 0119 Rev. B $ 250.00
Plexi Stand (3) PB 000 0042 $ 25.00
Patient Education Guide, Veins PB 000 0017 Rev. B $ 25.00
SUBTOTAL
APPLICABLE SALES TAX
ESTIMATED SHIPPING & HANDLING
TOTAL AMOUNT BILLED
Fax your order to LUMENIS Customer Service 408-764-3014 or call toll free 1-877-LUMENIS for your customer
support representative in the U.S. Outside of the U.S. please contact your local LUMENIS distributor.
Payment Information:
❏ American Express
❏ Visa
❏ MasterCard
❏ Discover
Card No:
Exp. Date:
Name (on credit card):
Signature:
Billing Address (for Credit Card):
Shipping Options: (Please check one)
❏ UPS Red (Overnight Service)
❏ UPS Blue (2 Days Service)
❏ UPS Orange (3 Days Service)
❏ UPS Ground (5-7 Business Days)

Upon receipt of this
fax, a customer
support representative
will call you back
with a confirmation
number and an estimated
time of arrival
for your order.
Page 2 of 2
IPL Skin Treatments Part Unit Qty. Total
Using Photorejuvenation Number Price Price
Poster IPL Photorejuvenation - Before and After PB P00 0074 Rev. B $ 20.00
Counter Display - Advertisement A PB P00 0067 Rev. B $ 10.00
Counter Display - Before and After PB P00 0075 Rev. B $ 10.00
Patient Brochures (Package of 50) PB P00 0005 Rev. B $ 35.00
Patient Postcards - Advertisement A (Package of 50) PB P00 0065 Rev. B $ 25.00
Patient Slide Presentation and Script PB P00 0064 Rev. B $ 350.00
Patient Education Guide (XLG-Size) PB 000 0062 Rev. B $ 25.00
IPL Hair Removal
Poster - Before and After PB 000 0101 Rev. B $ 20.00
Counter Display - Advertisement A PB 000 0095 Rev. B $ 10.00
Counter Display - Before and After PB 000 0097 Rev. B $ 10.00
Hair Removal Patient Brochure (Package of 50) PB P00 0003 Rev. B $ 35.00
Patient Postcards - Advertisement A (Package of 50) PB 000 0098 Rev. B $ 25.00
Patient Slide Presentation and Script PB 000 0111 Rev. B $ 350.00
SUBTOTAL
APPLICABLE SALES TAX
ESTIMATED SHIPPING & HANDLING
TOTAL AMOUNT BILLED
MATERIALS ORDER FORM
Payment Information:
❏ American Express
❏ Visa
❏ MasterCard
❏ Discover
Card No:
Exp. Date:
Name (on credit card):
Signature:
Billing Address (for Credit Card):
Shipping Options: (Please check one)
❏ UPS Red (Overnight Service)
❏ UPS Blue (2 Days Service)
❏ UPS Orange (3 Days Service)
❏ UPS Ground (5-7 Business Days)
Fax your order to LUMENIS Customer Service 408-764-3014 or call
toll free 1-877-LUMENIS for your customer support representative in the U.S.
Outside of the U.S. please contact your local LUMENIS distributor.