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ORDER FORM
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Professional
Portable
Super Lightweight Portable
Stationary
Chiropractic
Portable
Head Cradle/Face
Holes Options
Accessories
Table Weights Shipping
Repair
Parts / Special Item Pricing
About
Us
Brochure
Request
Testimonials
Order Form
HOME
Cost VS.
Ethics
Links
of Enlightenment |
|
Print out order form, fill out accordingly, and fax or send in with check
to address above. You are more than welcome to call order in @
800-368-5483 Monday through Friday,
10:00 am to 5:00 pm Pacific time. |
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| 1)
PROFESSIONAL
SERIES:
(click here to
see model) |
| ____QUASAR III @27.5
lbs. (12.47 kg) |
33.5 X 73" (86 cm X 185 cm)
|
$
565.00 |
| ____LUMINA III @24.5
lbs. (11.11 kg) |
29.5 X 73" (75 cm X 185 cm)
|
$
555.00 |
| ____STARLITE III
@ 23.5 lbs. (10.66 kg) |
27.5
X 73" (70 cm X 185 cm) |
$
545.00 |
| ____PULSAR III
@ 21.0 lbs. ( 9.53 kg) |
25.5
X 69" (65 cm X 175 cm) |
$
535.00 |
| 1a)
LEG
HEIGHT: (Height indicate
working surface of table) |
____17)
21-30" (53-76 cm)
____18) 22-31" (56-79 cm) |
____19) 23-32" (58-81 cm)
____21) 25-34" (64-86 cm) |
$ N/C |
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|
| 2)
SUPER LIGHTWEIGHT SERIES:
(click here to
see model) |
| ____COSMOS III
@ 25.5 lbs. (11.57 kg) |
33.5 X 73" (85 cm X 185 cm)
|
$
455.00 |
| ____VENUS III
@ 22.5 lbs. (10.21 kg) |
29.5 X 73" (75 cm X 185 cm)
|
$
450.00 |
| ____MERCURY
III
@ 21.5 lbs. (9.75 kg) |
27.5
X 73" (70 cm X 185 cm) |
$
445.00 |
| ____TAURUS
III
@ 20.75 lbs. (9.41kg) |
25.5
X 73" (65 cm X 185 cm) |
$
440.00 |
| 2a)
LEG HEIGHT: (Height
indicate working surface of table) |
|
____L) 22.5-31.5" (57-80 cm)
_____T) 24.5-33.5" (62-85cm) |
$ N/C |
| |
| 3)
STATIONARY
SERIES: (click here to
see model) |
| ____VENUS Stat
III @ 31.25 lbs. ( 14.17 kg) |
29.5 X 73" (75 cm X 185 cm)
|
$
345.00 |
| ____MERCURY Stat
III @ 29.25 lbs. (13.27kg) |
27.5
X 73" (70 cm X 185 cm) |
$
340.00 |
| ____TAURUS Stat
III @ 27.25 lbs. ( 12.36 kg) |
25.5
X 73" (65 cm X 185 cm) |
$
335.00 |
| 3a)
LEG
HEIGHT: (Height
indicate working surface of table) |
|
____L) 22.5-31.5" (57-80 cm) |
____T) 24.5-33.5" (62-85cm) |
$ N/C |
| |
| 4)
CHIROPORT: (click
here to see model) |
____CHIROPORT
III @ 16 lbs. (7.26 kg)
(Includes 5 position head piece. Available in Levante Vinyl
only.) |
17.5 X 53" (45 cm X
165 cm) |
$
435.00 |
____CHIROPORT
III-20 @ 16.5 lbs. (7.48 kg)
(Includes 5 position head piece. Available in Levante Vinyl
only.) |
20 X 53"
(51 cm X 165 cm) |
$
440.00 |
____CHIROPORT
III-22 @ 17 lbs. (7.71 kg)
(Includes 5 position head piece. Available in Levante Vinyl
only.) |
22 X 53"
(56 cm X 165 cm) |
$
445.00 |
____CHIROPORT
III-BN @ 19 lbs. (8.62 kg)
(Includes 5 position head piece and Lock Rod accessory. Available in
Levante Vinyl
only.) |
22 X 59"
(56 cm X 180 cm) |
$
495.00 |
| ____Foot
Cutout For Chiroport-BN table (Cost Non-Refundable if table returned) |
$
50.00 |
| ____Lock
Rod (Included with the Chiroport III-BN model) |
$
50.00 Net |
| ____Custom
Leg Height 16.5"-22.5" (This deems SALE FINAL) |
$
40.00 Net |
| ____Custom
Yin-Yang Design (This deems SALE FINAL) |
$
40.00 Net |
| ____Foot
Support ; Add lb. (.45 kg) (Cost Non-Refundable if table returned) |
$
65.00 |
| ____Foot
Support for Foot Cutout ; Add lb. (.45 kg) (This deems SALE FINAL) |
$
105.00 |
| ____Arm
Support Set (Cost Non-Refundable if table returned) |
$
55.00 |
| ____Cotton/Poly
Pad Covers; (Set of 2) $ 9.00/
Set
1/2 Dozen |
$
50.00 |
| ____Travel
Case (in Charcoal Grey only) For CHIROPORT III and 22 |
$
80.00 |
| ____Travel
Case (in Charcoal Grey only) For CHIROPORT III-BN |
$
85.00 |
| |
| 5)
LEVANTE UPHOLSTERY COLORS: (See
color Sample chart) |
____Hunter
____Black
____Agate
____Burnt Rose
____Burgundy ____Teal
____Mushroom ____Flint Grey
____White |
N/C
|
| |
| 6)
ULTRA-LEATHER COLORS: (See
color Sample chart) Subtract 1 lb (.45 kg) |
____Juniper
____Baltic ____Berry
____Brick ____Shetland
____Papyrus ____Raven Wing ____Dove
Grey ____Marine ____Plum
|
$
145.00 |
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|
7) CUSTOM TABLE OPTIONS:
(These items make SALE FINAL)
|
| ____Regular
Face Hole
only
$ 55.00 |
With
Plug $
70.00 |
| |
____In Ultra-Leather $ 100.00 |
With
Plug
$125.00 |
| ____Crescent
Face Hole
only $
95.00 |
With
Plug
$115.00 |
| |
____In Ultra-Leather $135.00 |
With
Plug
$175.00 |
| ____Foot
Support ; Add 1.75 lbs. (.79 kg) |
$
65.00 |
| ____Foot
Support in Ultra-Leather ; Add 1.5 lbs. (.68 kg) |
$
95.00 |
| 8)
OTHER OPTIONS: |
| ____Extra
3/4" Foam ; Add 2 lbs. (.91 kg) |
$
45.00 |
| ____Extra
FIRM Foam ; Add 2.5 lbs. (1.14 kg) SALE FINAL (Add
$5.00 for Cosmos or Quasar model table) |
$
55.00 NET |
| ____FIRM
Landau Foam ; Add 1 lbs. (.45 kg) SALE FINAL |
$ 125.00 NET |
| ____4
MM Baltic Birch Ply ; Add 1.5 lbs. (.68 kg) |
$
25.00 |
____Maxi
Tilt Head Cradle ; Add 1.5 lbs. (.68 kg)
(Includes C 3 P face pillow)
Available on Super lightweight Series Only |
$ 110.00 |
____Full
Adjustable Tilting Head Cradle ; Add 1.5 lbs. (.68 kg)
(Includes C 3 P face pillow) |
$
90.00 |
____Standard
Non Adjust Head Cradle ; Add 1.5 lbs. (.68 kg)
(Includes C 3 P face pillow) |
$
50.00 |
____
Semi Adjust Head Cradle ; Add 1.5 lbs. (.68 kg)
(Includes C 3 P face pillow) |
$
60.00 |
| ____Rubber
Feet (in gray only) |
$
20.00 |
| ____Other___________________________________________ |
|
| ____________________________________________________ |
$
. |
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9)
ACCESSORIES: (click
here to go to accessory page)
Note: All items will be sent in table
color unless otherwise noted. |
| ____Travel
Case (For all tables other than Chiroport
Series tables.) |
$
90.00 |
| ____Knee
Cushion / Color: |
$
30.00 |
| ____Knee
Cushion in Ultra-Leather/ Color: |
$ 55.00 |
| ____FLUFFY
Bolster/ Color: |
$ 35.00 |
| ____FLUFFY
Bolster in Ultra-Leather/ Color: |
$ 65.00 |
| ____MIT
Bolster/ Color: |
$ 35.00 |
| ____MIT
Bolster in Ultra-Leather/ Color: |
$ 65.00 |
| ____DM
Bolster Set / Color: |
$ 40.00 |
| ____DM
Bolster in Ultra-Leather/ Color: |
$ 75.00 |
| ____Neck
Contour Cushion/ Color: |
$ 25.00 |
| ____Neck
Contour Cushion Ultra-Leather / Color: |
$ 45.00 |
| ____Neck
Cushion/ Color: |
$ 20.00 |
| ____Neck
Cushion in Ultra-Leather/ Color: |
$ 30.00 |
| ____ZB
Head Support / Color: |
$
25.00 |
| ____ZB
Head Support in Ultra-Leather/ Color: |
$ 45.00 |
| ____Arm
Support Extender Set/ Color: |
$ 55.00 |
| ____Arm
Support Extender Set in Ultra-Leather/ Color: |
$ 95.00 |
| ____Shoulder
Support / Color: |
$ 25.00 |
| ____Shoulder
Support Set in Ultra-Leather/ Color: |
$ 45.00 |
| ____Chest
Support Set/ Color: |
$ 30.00 |
| ____Chest
Support Set in Ultra-Leather/ Color: |
$ 55.00 |
| ____Head
Cradle Arm Rest/ Color: |
$ 30.00 |
| ____Head
Cradle Arm Rest Ultra-Leather/
Color: |
$ 55.00 |
| ____C3P
Face Pillow/ Color: |
$ 20.00 |
| ____C3P
Face Pillow in Ultra-Leather/ Color: |
$ 40.00 |
| ____Face
Pillow Covers QTY______ @
$8.00 each |
$____.___ |
| ____1/2
Dozen (6) Face Pillow Covers @ $
40.00/ ½ dozen |
$____.___ |
| ____1
Dozen (12) Face Pillow Covers @ $
80.00/dozen |
$____.___ |
|
____Fitted Drawstring Sheet; White only |
$35.00 |
|
____Flat Sheet; White only |
$15.00 |
|
____Sheet Set; 1-Fitted and 1-Flat; White
only |
$45.00 |
|
SUBTOTAL
|
$______._____ |
|
Special
PROMO CODE____________ |
<$
. > |
|
CA Tax (Call for
Rates) |
$______._____ |
|
SHIPPING (See Shipping
Chart) |
$______._____ |
|
Total due |
$______._____ |
All information
in Blue must be filled in to complete order. For questions, contact us at
800-368-5483, or 831-763-0397, or email
us.
Billing Information:
BILLING NAME:_____________________________________________
ADDRESS:___________________________________________________
CITY, ST:_____________________________ ZIP
CODE:_____________ COUNTRY:__________________________
PHONE (______)_________________ FAX(______)__________________
EMAIL:__________________________________
Note:
For credit card orders, billing information must be the same as on credit
card statement.
Shipping Information: ____Same as Billing address
NAME:_____________________________________________
ADDRESS:___________________________________________________
CITY, ST:_____________________________ ZIP
CODE:_____________ COUNTRY:__________________________
PHONE (______)_________________ FAX(______)__________________
EMAIL:__________________________________
|
Method
of Payment: CHECK
M.O. VISA MC
DISCOVER AMX
MAKE CHECKS PAYABLE TO: ASTRA-LITE
INC.
* All personal or business checks must have ID
number written on check with a physical address and phone number. No
starter checks please. |
CREDIT CARD #__________-__________-__________-__________
EX.
DATE:_______/________
SIGNATURE:_____________________________________ |
| RETURN
POLICY: ALL ITEMS MAY BE RETURNED WITHIN 30 DAYS IN ORIGINAL
PACKAGING FOR A FULL REFUND
EXCLUDING SHIPPING; THIS IS APPLICABLE IN THE
CONTINENTAL U.S. ONLY AND IS NOT APPLICABLE ON STUDIO SERIES TABLES. ALL
RETURNS MUST BE APPROVED BY ASTRA-LITE PRIOR TO RETURN AND IN LIKE NEW CONDITION. |