PROFESSIONAL ORDER FORM - Waterpik
PROFESSIONAL ORDER FORM - Waterpik PROFESSIONAL ORDER FORM - Waterpik
WATERPIK PROFESSIONAL ORDER FORM Place Order in Case Quantities Only. Continued from other side. QTY. Price Levels Price/Unit Total Waterpik ® Ultra Cordless Replacement Jet Tips (JT-450E) Jet Tip for Waterpik ® Ultra Cordless (WP-450) and High Pressure Jet Tip replacement for Waterpik ® Cordless (WP-360). Packs per case: 5. Suggested Patient Price $7.99 Waterpik ® Cordless Replacement Jet Tips (JT-360E) Low-Pressure Jet Tip (blue) for Waterpik ® Cordless (WP-360). Two-pack. Packs per case: 5. Suggested Patient Price $7.99 Waterpik ® Replacement Toothbrush Tips (TB-100E) New Toothbrush Tips for Waterpik ® WP-100, WP-450. Two-pack. Packs per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 5-10 CARDS 6.79 15+ CARDS 5.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Replacement Orthodontic Tips (OD-100E) Orthodontic Tip for Waterpik ® WP-100, WP-450. Packs per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Replacement Pik Pocket TM Tips (PP-100E) Pik Pocket TM Tip for Waterpik ® WP-100, WP-450. Two-pack. Packs per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Replacement Tongue Cleaner Tips (TC-100E) Tongue Cleaner Tip for Waterpik ® WP-100, WP-450, WP-360. Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Sensonic ® Professional Replacement Advanced Brushes (2SRB-2W) Standard Brushes for Sensonic ® Professional Toothbrush Model SR-1000W. (2 pack color-coded brushes). Cards per case: 5. Suggested Patient Price $8.99 5-10 CARDS 7.64 15+ CARDS 6.74 Waterpik ® Sensonic ® Professional Replacement Compact Brushes (SRSB-2) Compact Brushes for Sensonic ® Professional Toothbrush Model SR-1000W. (2 pack color-coded compact brushes) Cards per case: 5. Suggested Patient Price $8.99 5-10 CARDS 7.64 15+ CARDS 6.74 Waterpik ® Sensonic ® Professional Replacement Interdental Brushes (2SIP-2W) Interdental Brushes for Sensonic ® Professional Toothbrush Model SR-1000W. (2 pack color-coded interdental brushes). Cards per case: 5. Suggested Patient Price $8.99 5-10 CARDS 7.64 15+ CARDS 6.74 Waterpik ® Power Flosser Whitening Replacement Tips (FTW-01) 30 disposable mint-flavored whitening tips. Use with Models FL-110, FLW-110, FLA-220 and FLW-310. Cards per case: 6. Suggested Patient Price $4.99 6 CARDS 4.24 12+ CARDS 3.74 Waterpik ® Power Flosser Replacement Tips (FT-01) 30 disposable flossing tips. Use with Models FL-110, FLW-110, FLA-220 and FLW-310. Cards per case: 6. Suggested Patient Price $3.99 6 CARDS 3.39 12+ CARDS 2.99 Waterpik ® Replacement Jet Tips (JT-70E) Jet Tip replacement tips for WP-60, WP-65, WP-70, WP72, WP-75. Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Replacement Pik Pocket TM Tips (PP-70E) Pik Pocket TM replacement tips for WP-60, WP-65, WP-70, WP72, WP-75. Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Waterpik ® Replacement Tongue Cleaner Tips (TC-70E) New Tongue Cleaner replacement tips for WP-60, WP-65, WP-70, WP72, WP-75. Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99 5-10 CARDS 6.79 15+ CARDS 5.99 Subtotal From This Side FN 20010233OPD-F AK • PN 20010233-OPD
WATERPIK <strong>PROFESSIONAL</strong> <strong>ORDER</strong> <strong>FORM</strong><br />
Place Order in Case Quantities Only.<br />
Continued from other side.<br />
QTY. Price Levels Price/Unit Total<br />
<strong>Waterpik</strong> ® Ultra Cordless Replacement Jet Tips (JT-450E)<br />
Jet Tip for <strong>Waterpik</strong> ® Ultra Cordless (WP-450) and High Pressure Jet Tip replacement<br />
for <strong>Waterpik</strong> ® Cordless (WP-360). Packs per case: 5. Suggested Patient Price $7.99<br />
<strong>Waterpik</strong> ® Cordless Replacement Jet Tips (JT-360E)<br />
Low-Pressure Jet Tip (blue) for <strong>Waterpik</strong> ® Cordless (WP-360). Two-pack.<br />
Packs per case: 5. Suggested Patient Price $7.99<br />
<strong>Waterpik</strong> ® Replacement Toothbrush Tips (TB-100E)<br />
New<br />
Toothbrush Tips for <strong>Waterpik</strong> ® WP-100, WP-450.<br />
Two-pack. Packs per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Replacement Orthodontic Tips (OD-100E)<br />
Orthodontic Tip for <strong>Waterpik</strong> ® WP-100, WP-450.<br />
Packs per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Replacement Pik Pocket TM Tips (PP-100E)<br />
Pik Pocket TM Tip for <strong>Waterpik</strong> ® WP-100, WP-450. Two-pack.<br />
Packs per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Replacement Tongue Cleaner Tips (TC-100E)<br />
Tongue Cleaner Tip for <strong>Waterpik</strong> ® WP-100, WP-450, WP-360.<br />
Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Sensonic ® Professional Replacement Advanced Brushes (2SRB-2W)<br />
Standard Brushes for Sensonic ® Professional Toothbrush Model SR-1000W.<br />
(2 pack color-coded brushes). Cards per case: 5. Suggested Patient Price $8.99<br />
5-10 CARDS 7.64<br />
15+ CARDS 6.74<br />
<strong>Waterpik</strong> ® Sensonic ® Professional Replacement Compact Brushes (SRSB-2)<br />
Compact Brushes for Sensonic ® Professional Toothbrush Model SR-1000W.<br />
(2 pack color-coded compact brushes)<br />
Cards per case: 5. Suggested Patient Price $8.99<br />
5-10 CARDS 7.64<br />
15+ CARDS 6.74<br />
<strong>Waterpik</strong> ® Sensonic ® Professional Replacement Interdental Brushes (2SIP-2W)<br />
Interdental Brushes for Sensonic ® Professional Toothbrush Model SR-1000W.<br />
(2 pack color-coded interdental brushes).<br />
Cards per case: 5. Suggested Patient Price $8.99<br />
5-10 CARDS 7.64<br />
15+ CARDS 6.74<br />
<strong>Waterpik</strong> ® Power Flosser Whitening Replacement Tips (FTW-01)<br />
30 disposable mint-flavored whitening tips.<br />
Use with Models FL-110, FLW-110, FLA-220 and FLW-310.<br />
Cards per case: 6. Suggested Patient Price $4.99<br />
6 CARDS 4.24<br />
12+ CARDS 3.74<br />
<strong>Waterpik</strong> ® Power Flosser Replacement Tips (FT-01)<br />
30 disposable flossing tips.<br />
Use with Models FL-110, FLW-110, FLA-220 and FLW-310.<br />
Cards per case: 6. Suggested Patient Price $3.99<br />
6 CARDS 3.39<br />
12+ CARDS 2.99<br />
<strong>Waterpik</strong> ® Replacement Jet Tips (JT-70E)<br />
Jet Tip replacement tips for WP-60, WP-65, WP-70, WP72, WP-75.<br />
Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Replacement Pik Pocket TM Tips (PP-70E)<br />
Pik Pocket TM replacement tips for WP-60, WP-65, WP-70, WP72, WP-75.<br />
Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
<strong>Waterpik</strong> ® Replacement Tongue Cleaner Tips (TC-70E)<br />
New<br />
Tongue Cleaner replacement tips for WP-60, WP-65, WP-70, WP72, WP-75.<br />
Tips per card: 2. Cards per case: 5. Suggested Patient Price $7.99<br />
5-10 CARDS 6.79<br />
15+ CARDS 5.99<br />
Subtotal From This Side<br />
FN 20010233OPD-F AK • PN 20010233-OPD
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