Clinician Order Form - FemCap™

Clinician Order Form

We are pleased to provide FemCap Clinician’s Kit and FemCap retail packages to you at the professional’s price. These items can be ordered only by medical practitioners and clinicians.

FemCap Clinician Fitting Kit (only 1 per clinic, please)

FemCap Clinician Fitting Kit is for clinic use only (not for distribution to or use with patients). The kit contains; three devices (Size 22m, 26m, and 30m), and all the needed instructions and literature, including links to online multi-lingual instructional videos.

FemCaps Retail Packages

FemCap retail packages include FemCap device and instructional materials.

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FemCap Clinician Fitting kit$105.00
FemCap – Single unit – 30mm$74.00
FemCap – Single unit – 26mm$74.00
FemCap – Single unit – 22mm$74.00
Total Price: