Customer Information:

First Name:
Middle Initial:
Last Name:
Address:
City:
State:
Zip Code:
Phone Number:

     Order Information:

     We offer only Ray-O-Vac Pro-Line batteries, the number one ranked hearing aid battery. We supply only 48-packs  of batteries      to provide the maximum discount to our patients.

     All sizes are $30.00 (including tax) per 48-pack. Shipping is $1.00

     Please select the size and quantity of batteries you wish to purchase by filling out the form below.

SIZE
QUANTITY
PRICE
TOTAL
10
48-packs
$  $
13
48-packs
$  $
312
48-packs
$  $
675
48-packs
$  $
    Total:
$
Shipping Charges: $
Amount Due: $

     Payment Information:

       Mailing your order form:

Once your order prints out, please fill in the Payment Options section. Please enclose a check, or if a current patient of Dr. Ruggle or Dr. Gillum, you may have your account debited and simply pay at your next visit. If you wish to pay by credit card, please provide your credit card information on thie printed form. Your information can be kept on file to make your future purchases easier and faster. If you wish to keep your information on file, please check the appropriate box on the printed form.

You may also complete this order by calling the toll free number 1-800-286-4046. Please feel free to call us with any questions regarding hearing aid battery purchases.

Please click the Print button below to complete the order process.

 

 

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