Please Place Your Comfeeze Order, Request with this form.

1-10 Pkg $20.50/Pkg 100-199 Pkg $2.49 / set 200 - 400 sets $2.29 / set 400 + sets $1.99 / set

Your Full Name:

Street Address:

City:

State/Province, (and country if not USA):

Zip Code:

E-mail Address:

Phone number:

Fax number:

If you Are Requesting A Free Sample, Please print this form then mail/fax

If you are Placing an order, and would like to Mail or Fax your information to us, please print this form and mail or fax to:

Please make all Checks Payable to:

RoMedLLC
4224 Massachusetts St., Long Beach, CA 90814 Telephone: (562) 438-8904, Fax (562) 438-8904
E-mail: RoMedllc@aol.com

For All Credit Card Orders, we will contact you for payment information.

Please choose from the following:

For more information or if you have any questions, feel free to contact us:

Romaine A. Settle, R.N.
RoMedLLC
4224 Massachusetts St., Long Beach, CA 90814 Telephone: (562) 438-8904, Fax (562) 438-8904
E-mail: RoMedllc@aol.com

Last updated by Andrew Lopez, RN on Thursday May 27, 2010

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