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  Lamp Order Form

For more efficient service, please be prepared to answer ALL of the questions below, as they apply to your bed(s). Many of the answers can be found on your OEM plate attached to the bed.

More information may be required after review of your Order Form.

* Customer Name:
* Salon Name:
* Phone Number:
* Email Address:
Bed Information  
        * Manufacturer
        * Make
        * Model
* Total number of lamps:
* High Pressure Bed? Yes       No
Bench Lamps  
         Quantity
         Length (59”, 71”, 2M, etc)
         Wattage (100W, 200W, etc)
         End Type (Bi-Pin, RDC)
         Etch Information
         (Writing at the end of the lamp)
Canopy Lamps  
         Quantity
         Length (59”, 71”, 2M, etc)
         Wattage (100W, 200W, etc)
         End Type (Bi-Pin, RDC)
         Etch Information
         (Writing at the end of the lamp)
Facial Lamps (Low Pressure Beds)  
         Quantity
         Wattage (100W, 200W, etc)
         Type (Clip In, Wire Lead, etc)
Shoulder Lamps (If Applicable)  
         Quantity
         Wattage (100W, 200W, etc)
         Type (Clip In, Wire Lead, etc)
Optional: You may include an image of your lamp(s) with your form submission.

Max allowed files size is 2MB
Alllowed file types are:
jpg, gif, bmp, png and pdf.



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Parts & Service: 800-223-7794



 

 

 
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