* = Required Information
Name
*
First
Last
Phone
*
-
-
The first box must be 3 characters
The second box must be 3 characters
The third box must be 4 characters
(###)
###
###
Email
*
Shipping Address
Street Address
Address Line 2
California
City
State / Province / Region
Are you a Kaiser Permanente patient?
Yes
No
Sigvaris Medical/Well Being/Sports
Select
Access
120 Sheer Fashion
142 Cushioned Cotton
146 Casual Cotton
180 Classic Ribbed
182 Cushioned Cotton
186 Casual Cotton
189 Business Casual
230 Cotton
360 Cushioned Cotton
401 Athletic Recovery Socks
412 Performance Socks
412 Performance Sleeves
421 Merino Outdoor Socks
422 Merino Outdoor Performance Socks
602 Diabetic Compression Sock
710 Allure
770 Truly Transparent
780 Eversheer
840 Soft Opaque
860 Select Comfort
910 Advance Armsleeve
Select compression
Select
15-20 mmHg
18-25 mmHg (602 Diabetic Compression Sock only)
20-30 mmHg
30-40 mmHg
40-50 mmHg (500 Natural Rubber only)
50-60 mmHg (500 Natural Rubber only)
Select size
Select
SP - Small Petite
SS - Small Short
SL - Small Long
MP - Medium Petite
MS - Medium Short
ML - Medium Long
LS - Large Short
LL - Large Long
XS - ExtraLarge Short
XL - ExtraLarge Long
Select applicable product style:
Women's Closed Toe
Men's Closed Toe
Unisex Open Toe
Knee-High (Calf)
Thigh-High
Pantyhose
Color (according to catalog)
Quantity (each box contains one pair)
Price List for Select Items (if your product is not listed, we will contact you with your final total before charging)
Click to view prices
Access 20-30 mmHg Knee-High (calf): $50.00
Access 30-40 mmHg Knee-High (calf): $50.00
Access 20-30 mmHg Thigh-High: $75.00
Access 30-40 mmHg Thigh-High: $75.00
Access 20-30 mmHg Pantyhose: $85.00
Access 30-40 mmHg Pantyhose: $85.00
Allure 15-20 mmHg Knee-High (Calf): $45.00
Allure 15-20 mmHg Thigh-High: $60
Allure 15-20 mmHg Pantyhose: $75.00
Eversheer 15-20 mmHg Knee-High (Calf): $45.00
Eversheer 15-20 mmHg Thigh-High: $60v
Eversheer 15-20 mmHg Pantyhose: $75.00
Soft Opaque 15-20 mmHg Knee-High (Calf): $45.00
Soft Opaque 15-20 mmHg Thigh-High: $60
Soft Opaque 15-20 mmHg Pantyhose: $75.00
Cotton 15-20 mmHg Knee-High (Calf): $45.00
Cotton 15-20 mmHg Thigh-High: $60
Cotton 15-20 mmHg Pantyhose: $75.00
Cushioned Cotton 15-20 mmHg Knee-High (Calf): $45.00
Cushioned Cotton 15-20 mmHg Thigh-High: $60
Cushioned Cotton 15-20 mmHg Pantyhose: $75.00
Men's Select Comfort 20-30 mmHg Knee-High (Calf): $75.00
Men's Select Comfort 20-30 mmHg Thigh-High: $100.00
Men's Select Comfort 30-40 mmHg Knee-High (Calf): $75
Men's Select Comfort 30-40 mmHg Thigh-High: $100.00
Natural Rubber 30-40 mmHg Knee-High (calf): $80.00
Natural Rubber 30-40 mmHg Thigh-High: $120.00
Diabetic Sock 18-25 mmHg Knee-High (Calf): $40.00
Athletic Recovery 15-20 mmHg Knee-High: $40.00
Sports Merino Wool 15-20 mmHg Knee-High: $45.00
Sports Merino Wool 20-30 mmHg Knee-High: $80.00
Sports Performance Sock 20-30 mmHg Knee-High: $70.00
Sports Sleeve 20-30 mmHg Knee-High: $45.00
Well Being 15-20 mmHg Knee-High (calf): $35.00
Well Being 15-20 mmHg Thigh-High: $55.00
Well Being 15-20 mmHg Pantyhose: $60.00
Advance Armsleeve without gauntlet 15-20 mmHg: $75.00
Advance Armsleeve without gauntlet 20-30 mmHg: $75.00
Advance Armsleeve with gauntlet 20-30 mmHg: $95.00
Sigvaris Accessories
Select
Rubber Gloves-Ridged: $8.50
Rubber Gloves-Wavy: $8.50
Latex-Free Gloves: $9.00
Doff N' Donner (without cone): $35.00
Doff N' Donner Cone: $25.00
Doff N' Donner with Cone: $55.00
Washing Solution Liquid 16 oz bottle: $12.00
It Stays Roll-On Liquid Adhesive: $13.00
Quantity
How would you like to receive your products?
I will pick it up from the store
I would like it delivered/shipped
Specific Instructions
Security Code
*