Consumable Parts Order Form
Dear Valued i-CAT Customer,
®
The following form can be used to order accessories for the i-CAT or Gendex CB500. Please indicate
how many of each item you would like to purchase, provide payment information, the shipping
address and method of shipment.
Please return the form via fax to 215-997-5665 or it can be emailed to ISIOrders@imagingsciences.com.
If you need any assistance or have any questions please contact the Parts Department at 215-997-5666
extension 3.
Thank you for your order and have a great day! ☺
Donna Ellison
Customer Service Administrator
215-997-5666 x 1324
Imaging Sciences International, LLC • 2800 Crystal Drive • Hatfield, PA 19440
Phone: 215-997-5666 • Fax: 215-997-5665 • www.i-CAT.com
Consumable Parts Order Form
PART NUMBER
PART DESCRIPTION
PRICE
QUANTITY REQUESTED
1.005.8616
Chin Cup (Contoured)
$11.18 for 2
1.006.9827
Chin Rest (Flat)
$7.62 for 2
1.006.3070
Bite Stick (i-CAT Classic)
min qty 2
$14.38 for 2
1.007.0552
Bite Stick (all other machs.)
min qty 2
$12.86 for 2
1.006.9826
Bite Tips (bag of 25)
$43.61 for bag
1.006.3389
Head Straps (50 per box)
$55.00 for box
1.006.6829
Velcro Head Restraint Kit
$30.00 for kit
1.006.3072
CMT – Biteblock (bag of 25) $13.50 for bag
Payment Information
Method of Payment:
AMEX
 Visa
MasterCard
Credit Card Number
Security Code
Expiration Date
Cardholder’s Name
(as it appears on card)
Cardholder’s Signature
Shipping Information
Contact Name
Mailing Address
City
State/Province
Zip Code
Country
E-Mail Address
Phone Fax
Shipping Method
FedEx Ground
FedEx Next Day
Prices quoted do not include transport charges and applicable sales tax.
Imaging Sciences International, LLC • 2800 Crystal Drive • Hatfield, PA 19440
Phone: 215-997-5666 • Fax: 215-997-5665 • www.i-CAT.com