Clinical Supplies - Fitting Consumables Order Form

To send your order please fill out the information below and your request will immediately be sent to your Lyric customer service representative. You can also call us with you order at 1 855 21 LYRIC (59742), Press 1 for Customer Service.

Clinic Information

* Required fields.


   

Contact Name:

*

Email Address:

*

Account Name:

*

Account Number:

*

Phone:

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Fitting Consumables
All Lyric fitting consumables are available at no charge.


         

Product Name:

Image:

Part:

Price:

Quantity:

Lyric2 Depth Sizers (10 pieces)

026-1270

$30.00

Lyric2 Sizer XS (10 pieces)

054-0697

$60.00

Lyric2 Sizer S (10 pieces)

054-0698

$60.00

Lyric2 Sizer M (10 pieces)

054-0699

$60.00

Lyric2 Sizer L (10 pieces)

054-0700

$60.00

Lyric2 Sizer XL (6 pieces)

054-0703

$60.00

Glycerin (10 pieces)

098-0369

$10.00