Order Lymphedema Alertbands today!

You can order alertbands of any quantity. We do require a shipping and handling charge of $20.00 per 100 alertbands ($20 for 1-100, $40 for 101-200, $60 for 201-300 etc). Additional materials including brochures, tri-folds, CDs etc can be sent also at no additional charge.

- you have an account with us:
  • Please fill out the form below and submit it. We will invoice you for the shipping and handling charges.

- you do not have an account with us:
  • If you would like to pay by phone, please contact us at 800-293-3362 with your credit card information.

  • If you would like to pay by fax, fill out this order form and fax it to 831-430-9068.

  • If you would like to pay by mail using a check, money order or credit card, fill out this order form and mail it to us at the following address.

    Peninsula BioMedical, Inc
    P.O. Box 66149
    Scotts Valley, CA 95067-6149

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* Name:
 * Company Name:
* Mailing Address Street:
* Mailing Address City:
* Mailing Address State/Prov.:
* Mailing Address Zipcode:
* Mailing Address Country:
* Services provided for Lymphedema patient's:  
* Also send information on our products and services?  Yes    No
* Quantity of arm alertbands requested:  
* Quantity of leg alertbands requested:  
   Total quantity of alertbands requested:  
   Total shipping and handling charges:  
* Email:
* Telephone Number: