Revolutionize Patient Recovery with Advanced Rehab Solutions Explore our solutions! Reach out for virtual demos and clinical webinars. ← Enter your details: Name: Email: State: Submit Form submitted successfully! Neuro Rehab Recovery Technology Order Form QUOTE #: Custom PO: Need By Date: PO #: Date: Bill To: Ship To: Attn: Attn: Address: Address: City: City: ST: ST: Tel: Tel: Zip: Zip: Billing Email: Shipping Email: Order Items Part No. Description Price Qty. Total G4G4 FES Foot Drop Kit$2,500.00 $0.00 G1XFT G1 EMG Robotic Glove$2,000.00 $0.00 Subtotal: $0.00 Sales Tax: Shipping: Total: $0.00 Date: ______________________ Quotes are only valid for 60 days. Prices are subject to change without notice. Caution: US Federal Law restricts the G4 device sales by physician prescription only. Submit Order
