TIAGRA CANES
ORDER FORM
ADDRESS
NAME
Free Shipping in the Continental USA!
STREET
CITY
STATE
ZIP
PHONE
EMAIL
It is very important that you refer to theMeasurement Procedure Instructionsbefore ordering.
MEASUREMENTS
in. cm.
Palm Width
Length from Center of Palm to Floor
Your Height
lbs. kg.
Your Weight
ADDITIONAL DATA
Your answers will help our consulting physician verify that you have chosen a cane most suitable to your needs and that you have measured yourself correctly.
1. Your overall upper body strength?
2. Your current cane length (if applicable)?
PRICE LIST
Tiagra Basic - Walnut:
$ 349.00
Tiagra Libra - Birdseye Maple:
$ 499.00
Tiagra Basic - Hornbeam:
Tiagra Libra - Rosewood:
Tiagra Basic - Cherry:
Tiagra Cosmic Eye - Walnut:
$ 369.00
For credit card payment, click on Paypal.
CHECK PAYMENT
If you prefer, you can pay with a check, by printing the PDF version of the order form, and mailing it along with a check made out to "MEDAR Corporation, Inc." to
Medar Corporation, Inc.P.O. Box 18172Asheville, N.C. 28814
Limited Warranty