(214) 377-8144 sales@dermitech.com

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Phototherapy Product Order Form

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I confirm that the above information is accurate and complete to the best of my knowledge. I agree to follow my prescriber’s instructions for the proper use of this medical device.
It is important to understand the size, weight and electrical requirements of your device. Please discuss these details and any special delivery needs you may have with your Dermitech representative by calling 214-377-8144. Read our terms.

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