Fluoro Visible Archives

Cryo Painblocker™: Setting a New Standard in Cryoneuroablation - EXPLORE

2022 Reimbursement Guide - LEARN MORE

Fluoro Visible

Fluoro-visibility is critical for physicians when using fluoroscopy as their imaging guidance during pain procedures. Epimed products are radiopaque, so they can be seen under C-Arm imaging to help during placement.

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This application is for facilities and practices located in the United States only. For all other countries, please Contact Sales.

This form is for United States applicants only. Non-US applicants should contact sales to learn more. Approvals can take up to 5 business days and additional information may be requested.

Clinic/Hospital Name*

Billing Address*

City*

State*

Zip*

Country*

Email for Invoices*

Buying Affliation*

Examples: HCA, Novation, etc.

Federal ID*

Tax Exempt*

Is the facility exempt from paying sales tax?*

Yes

Upload Tax Exempt Certificate*

Accepted file types: pdf, png, jpg, Max. file size: 1 MB.

IHR-530 Rev. 12

Please provide a primary shipping address.

Shipping Address*

City*

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Zip*

County*

Country*

Telephone*

Fax

IHR-530 Rev. 12

Primary A/P Contact*

Phone*

Email*

Add more contacts?*

Yes

Please select:

Purchasing Agent

Materials Manager

Nurse

Risk Manager

Other Contact

Purchasing Agent

Phone

Materials Mgt

Phone

Nurse

Phone

Risk Manager

Phone

Other

Phone

IHR-530 Rev. 12

Physician Office*

City*

State*

Postal Code*

Country*

Email*

Telephone*

Fax

IHR-530 Rev. 12

Physician First Name*

Physician Last Name*

Degree*

Pain Practice Specialty*

IHR-530 Rev. 12

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Request Online Access

This form is for users that already have an Epimed account, but do not yet have online access.

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Purchasing Company Name(Required)

Purchasing Contact First Name(Required)

Purchasing Contact Last Name(Required)

PO Number for Last Order(Required)

This is for verification purposes.

Customer Number(Required)

This is located on your invoice.

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The username is permanent and cannot be changed in the future.

Create Password(Required)

You will be asked to update or change this in the future.

Display Name(Required)

This is what will display if you a leave a product review.

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This will be used as the contact email for online access.

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This field is for validation purposes and should be left unchanged.

Cryo Painblocker™: Setting a New Standard in Cryoneuroablation - EXPLORE

2022 Reimbursement Guide - LEARN MORE

Blunt Nerve Block Needles

Racz® Catheters

Tuohy Epidural Needles

Accura-C™

Chiba Needles

Wiley Spinal®

RX-2™ Coudé®

Cobra RF™

G-21 Epidural Catheter™

RX Epidural Needles

STEALTH™ Nerve Block Needle

Neo-Kath™ Set

Quincke Needles

RF™ Sharp Needles

RF-A™ Sharp Needles

R.K.™ Epidural Needles

Tuohy Single Shot Kit

VERSA-KATH®

SPIROL® Set

FETH-R-KATH™

BELLA-D® Needle

Flexible Introducer Cannula (FIC)

RF™ Blunt Needles

Blunt Access Cannula (BAC)

E-KATH™

Ultrasound Catheter Set CE

Day Needle

SPIROL® Catheter

Racz® Catheter MiniTray

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Request Online Access