{"id":550,"date":"2020-07-14T00:09:09","date_gmt":"2020-07-14T00:09:09","guid":{"rendered":"http:\/\/stimrouter.pixelsmith.co\/?page_id=550"},"modified":"2024-12-11T10:35:14","modified_gmt":"2024-12-11T17:35:14","slug":"order-supplies","status":"publish","type":"page","link":"https:\/\/stimrouter.com\/en\/patients-targeted-relief\/patient-resource-center\/order-supplies\/","title":{"rendered":"Order StimRouter Supplies"},"content":{"rendered":"\n<div id=\"acf\/banner-block_fb0e6450bd0202b0a8bdabeeb908fe10\" class=\"pxblock pxblock--banner banner text-color--light height--short\">\n\t\n\t<div class=\"container\">\n\t\t\t\t\t<div class=\"banner__content\">\n\t\t\t\t<h1>Order StimRouter Supplies<\/h1>\n\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t<img decoding=\"async\" class=\"banner__wave\" src=\"\/wp-content\/themes\/stimrouter\/assets\/images\/wave-image.svg\">\n\t<\/div>\n\n\n\n<div id=\"acf\/text-block_41b80b8c6d77ecadd71673e24c1d8fe1\" class=\"pxblock pxblock--text text width--default\">\n\t\n\t<div class=\"container\">\n\t\t<h4>The disposables required for the ongoing use of the StimRouter are called Gel Electrode Patches and should be changed every 2 to 4 days depending on use.<\/h4>\n<p>&nbsp;<\/p>\n<h2>Order Gel Electrode Patches<\/h2>\n<p>Fill out the Supply Order form below with your requested supplies and prescription information to get started. Alternately, you may contact Client Relations Department at (800) 211-9136 to order supplies.<\/p>\n\t<\/div>\n<\/div>\n\n\n\n<style>\n\t@media (min-width: 768px) {\n\t\t.columns__row > .columns__column.columns__column--1 {\n\t\t\twidth: 100%;\n\t\t}\n\t}\n<\/style>\n\n<div id=\"acf\/columns-block_e2cc46fd3849e76e3ad70ec04325c2ef\" class=\"pxblock pxblock--columns columns\">\n\t\n\t<div class=\"container\">\n\t\t\n\t\t<div class=\"columns__row\">\n\t\t\t\t\t\t\t<div class=\"columns__column columns__column--1\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"columns__content\">\n\t\t\t\t\t\t\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f7170-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"7170\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/550#wpcf7-f7170-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"7170\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f7170-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<table class=\"order-online\">\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">First Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Last Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Date of Birth<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-birth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"MM\/DD\/YYYY\" value=\"\" type=\"text\" name=\"date-of-birth\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Phone Number<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Email<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label class=\"required\">Address<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label class=\"required\">Street Address<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"street-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"street-address\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">City<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><label class=\"required\">State<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"state\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Alabama\">Alabama<\/option><option value=\"Alaska\">Alaska<\/option><option value=\"Arizona\">Arizona<\/option><option value=\"Arkansas\">Arkansas<\/option><option value=\"California\">California<\/option><option value=\"Colorado\">Colorado<\/option><option value=\"Connecticut\">Connecticut<\/option><option value=\"Delaware\">Delaware<\/option><option value=\"District of Columbia\">District of Columbia<\/option><option value=\"Florida\">Florida<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Hawaii\">Hawaii<\/option><option value=\"Idaho\">Idaho<\/option><option value=\"Illinois\">Illinois<\/option><option value=\"Indiana\">Indiana<\/option><option value=\"Iowa\">Iowa<\/option><option value=\"Kansas\">Kansas<\/option><option value=\"Kentucky\">Kentucky<\/option><option value=\"Louisiana\">Louisiana<\/option><option value=\"Maine\">Maine<\/option><option value=\"Maryland\">Maryland<\/option><option value=\"Massachusetts\">Massachusetts<\/option><option value=\"Michigan\">Michigan<\/option><option value=\"Minnesota\">Minnesota<\/option><option value=\"Mississippi\">Mississippi<\/option><option value=\"Missouri\">Missouri<\/option><option value=\"Montana\">Montana<\/option><option value=\"Nebraska\">Nebraska<\/option><option value=\"Nevada\">Nevada<\/option><option value=\"New Hampshire\">New Hampshire<\/option><option value=\"New Jersey\">New Jersey<\/option><option value=\"New Mexico\">New Mexico<\/option><option value=\"New York\">New York<\/option><option value=\"North Carolina\">North Carolina<\/option><option value=\"North Dakota\">North Dakota<\/option><option value=\"Ohio\">Ohio<\/option><option value=\"Oklahoma\">Oklahoma<\/option><option value=\"Oregon\">Oregon<\/option><option value=\"Pennsylvania\">Pennsylvania<\/option><option value=\"Rhode Island\">Rhode Island<\/option><option value=\"South Carolina\">South Carolina<\/option><option value=\"South Dakota\">South Dakota<\/option><option value=\"Tennessee\">Tennessee<\/option><option value=\"Texas\">Texas<\/option><option value=\"Utah\">Utah<\/option><option value=\"Vermont\">Vermont<\/option><option value=\"Virginia\">Virginia<\/option><option value=\"Washington\">Washington<\/option><option value=\"West Virginia\">West Virginia<\/option><option value=\"Wisconsin\">Wisconsin<\/option><option value=\"Wyoming\">Wyoming<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Zip Code<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zip-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip-code\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">How do you prefer your order be shipped?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"shipped-name\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"shipped-name\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"USPS\">USPS<\/option><option value=\"FedEx\">FedEx<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Order Gel Electrode Patches<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"electrode-patches\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"electrode-patches\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"1 box - $35\">1 box &#8211; $35<\/option><option value=\"Buy 2 boxes, get 1 box free - $70\">Buy 2 boxes, get 1 box free &#8211; $70<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Prescribing Physician Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"physician-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"physician-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Prescribing Physician Phone Number<\/label><br \/>\n<span 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Bioventus.<\/small>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t<span class=\"wpcf7-form-control-wrap recaptcha\" data-name=\"recaptcha\"><span data-sitekey=\"6LfL22QqAAAAAH1xmP4oPng3KX0DzAc51zSYH5ok\" class=\"wpcf7-form-control wpcf7-recaptcha g-recaptcha\"><\/span>\r\n<noscript>\r\n\t<div class=\"grecaptcha-noscript\">\r\n\t\t<iframe loading=\"lazy\" src=\"https:\/\/www.google.com\/recaptcha\/api\/fallback?k=6LfL22QqAAAAAH1xmP4oPng3KX0DzAc51zSYH5ok\" frameborder=\"0\" scrolling=\"no\" width=\"310\" height=\"430\">\r\n\t\t<\/iframe>\r\n\t\t<textarea name=\"g-recaptcha-response\" rows=\"3\" cols=\"40\" placeholder=\"reCaptcha Response Here\">\r\n\t\t<\/textarea>\r\n\t<\/div>\r\n<\/noscript>\r\n<\/span>\n\t\t\t<p>By clicking submit, I consent to receive email and phone communications at the above provided email address and phone number sent from or on behalf of Bioventus.\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"115\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":29,"featured_media":0,"parent":546,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":true,"footnotes":""},"class_list":["post-550","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/comments?post=550"}],"version-history":[{"count":0,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/550\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/546"}],"wp:attachment":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/media?parent=550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}