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St Johns Health.
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Order Date
Appointment date
*
Please enter the date of your upcoming scheduled treatment. If exact date is unknown please enter approximate date.
This will be treatment number
*
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Please enter the number of your next upcoming treatment.
Number of days for Shipping
Do you need to order a DeltaKit?
A DeltaKit must be ordered prior to first treatment. The DigniCap DeltaKit is a single-patient use component of an FDA-regulated medical device. As such it cannot be returned once it is received by a patient – even if it has not been opened or used.
Yes - This is my first treatment and I need to purchase a DeltaKit
No - I have already purchased my DeltaKit
DeltaKit
Price:
Your DeltaKit will include your personal Cooling Wrap and Thermal Cap, as well as a detangling Wet Brush, spray bottle, and a Patient Guide.
DeltaKit
Price:
Your DeltaKit will include your personal Cooling Wrap and Thermal Cap, as well as a detangling Wet Brush, spray bottle, and a Patient Guide.
DeltaKit
Price:
Your DeltaKit will include your personal Cooling Wrap and Thermal Cap, as well as a detangling Wet Brush, spray bottle, and a Patient Guide.
DeltaKit
Price:
Your DeltaKit will include your personal Cooling Wrap and Thermal Cap, as well as a detangling Wet Brush, spray bottle, and a Patient Guide.
DeltaKit
Price:
Your DeltaKit will include your personal Cooling Wrap and Thermal Cap, as well as a detangling Wet Brush, spray bottle, and a Patient Guide.
State and Local Sales Tax
Price:
$0.00
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$0.00
Quantity
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$400.00
Quantity
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$265.00
Quantity
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$275.00
Quantity
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$450.00
Quantity
DeltaCard Treatment Cards
Quantity
*
Each DeltaCard is valid for one treatment only.
Additional cards can be purchased below or at a later time.
Price:
$250.00
Quantity
Required additional facility fees
Not Applicable
Required additional facility fees
150 Per Treatment Capping Service Fee
Required additional facility fees
100 Per Treatment Capping Service Fee
Required additional facility fees
100 Per Treatment Facility Fee
Required additional facility fees
125 Per Treatment Capping Service Fee
Shipping Option
Your order qualifies for free shipping and should arrive in 2-4 business days. If you need faster shipping, select a shipping option below.
FEDEX 2DAY
FEDEX STND OVRN
Shipping Option
Your order qualifies for free shipping and should arrive in 2-4 business days. If you need faster shipping, select a shipping option below.
FEDEX 2DAY
FEDEX STND OVRN
Shipping Option
Your scheduled treatment date requires next day shipping. There is a $40 fee for this expedited shipping.
FEDEX STND OVRN
Shipping Option
Your scheduled treatment date requires next day shipping. There is a $60 fee for this expedited shipping.
FEDEX STND OVRN
Shipping Option
Pickup at Facility
Please pickup at your facility
Total Cost
Notes
Notes
Order Summary
Date
Facility Name
Patient Name
Total Treatments
Regimen
Regimen-Other
Medical Oncologist
SKU
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Region
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Account Type
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Sales Tax
Subtotal
Options
Total
St Johns Health. quantity
Proceed to Checkout
SKU:
WY-3256p
Category:
West
Tag:
Delta
Description
Description
St. Johns Health
Jackson, WY
