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UCHealth Aurora
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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
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
Shipping Option
Your order qualifies for free regular ground shipping and should arrive in 2-4 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.
Next Day +60
Shipping Option
Pickup at Facility
Please pickup at your facility
Total Cost
Notes
Notes
Order Summary
Date
Facility Name
Patient Name
Total Treatments
Date of First Scheduled Treatment
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
UCHealth Aurora quantity
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SKU:
CO-2018
Category:
West
Tags:
Delta
,
Invoice
,
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Description
Description
UCHealth Aurora
