Order StimRouter Supplies

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.

Order Gel Electrode Patches

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.

First Name*
Last Name*
Date of Birth*
MM slash DD slash YYYY
Phone Number*
Email*
Address*
Street Address Address Line 2 City State ZIP Code
How do you prefer your order be shipped?*
Order Gel Electrode Patches*
Prescribing Physician Name*
Prescribing Physician Phone Number*
Upload Forms — ABN, Waiver, and/or Release Form
Drop files here or

Accepted file types: doc, jpg, pdf, Max. file size: 50 MB, Max. files: 3.
Attach your prescription information. This can be a scanned document or a photo of your prescription paperwork. Files types allowed are doc, jpg, or pdf. File must be less that 2MB in size.
CAPTCHA
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.