Biko PR Therapy Bands Order Form

Please provide us with detailed information about your dog, and indicate the product package that you are interested in. Upon reviewing all of your information, Annie Janis, Chief Innovation Officer will contact you, and possibly your veterinarian/rehab practitioner, by phone in order to determine appropriate resistance strength Bands for your dog. Payment will only be initiated once we determine the appropriate resistance strengths for your dog.

Biko PR Therapy Bands Order Form

Veterinary Practice Information
Name of Veterinarian
Name of Practice
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email
Patient Information
Name of Pet Parent
First Last
Email
Pet's Name
First
Age
Breed
Diagnosis/Condition
Measurements
Fit the dog with a Roman harness that has a D ring on the top (flat on the back)
A. Band Length: Measure the distance from the D ring to the metatarsals on the diagonal
B. Metatarsal Circumference: Measure the circumference of the metatarsal (between the tarsus and the paw)
Band Length: Left Side (inches)
Band Length: Right Side (inches)
Metatarsal Circumference: Left Side (inches)
Metatarsal Circumference: Right Side (inches)
Ordering Information
Biko Individual Kit* Quantity
Biko PR Bands individual kit contains three sets of PR Bands (yellow – light resistance, red – medium resistance, or green – strong resistance), one set of padded foot cuffs, and three sets of extenders.
Price: $225.00
Biko PR Bands Practice Therapy Kit Quantity
The Biko PR Bands Practice Therapy Kit comes complete with: one set of each resistance strength (yellow – light, red – medium, green – strong) in all seven sizes (21 pairs); seven sets of extender straps; one set of cuffs in each size (sizes 1 to 4); and Roman harnesses.
Price: $630.00
Pair of Padded Cuffs* Quantity
Price: $40.00
Pair of Resistance Bands* Quantity
Price: $75.00
*Professional courtesy offered to veterinary professionals
Total
$0.00
Billing
You will be billed after your order is processed.
An invoice will be sent to your email address, which can either be paid securely online, or by phone. We accept most major credit cards, Paypal, Venmo, or Zelle.
Shipping Information
Shipping to:
- Veterinary Practice Address
- Different Address
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email

Biko PR Therapy Bands Order Form

Biko PR Therapy Bands Order Form

Veterinary Practice Information

Patient Information

Measurements

Ordering Information

Billing

Shipping Information