The following forms are made available for you to download, print and copy as needed.
School Nurse Supply Order Form
If you would prefer a paper copy to either mail or fax in your order to us, then please use this form for all of your ordering needs.
New Clinic Start Up Form
This form lists all of the essential products that you will need to help get a new clinic up and running.
Medical Prescription/Authorization Form
The Medical Prescription/Authorization Form is required at the time of purchase when filling a prescription for and Automated External Defibrillator (AED), as well as all pediatric pads. AEDs are FDA regulated medical devices. A prescription to acquire the unit from a board-certified physician in the state the unit will be located in is required by federal regulation. In addition, a licensed physician or medical authority will ensure that all designated responders are properly trained; that the AED is properly maintained; and that the program meets all requirements, which may vary from state to state.
Product Return Form
School Nurse Supply guarantees your satisfaction on all products received from our company within 60 days of purchase. Use this Return Form when you are making a product return or exchange. All returns are subject to review and require prior authorization from our Return Department.
Calibration & Repair Order Form
Use this Repair Form when you are sending in equipment for repair. All repairs are subject to review and require prior authorization from our Repair Department. Please contact Customer Service Department at 800-485-2737 for complete instructions.
Optec $350 Trade-In Rebate Form
Stereo Optical is offering a $350 rebate when you trade-in your old vision screener for a NEW Optec 5000 or 5500 Vision Screener.
Titmus Vision Screener Trade-In Form
Honeywell is offering a manufacturer's allowance towards the purchase of a new Titmus V2 or V4 Vision Screener.
School Nurse Supply W-9 Form
Print this W-9 form with our information to be signed for your tax purposes.