Order the MiraColt™

Just fill out the form below, and we’ll be in touch to answer any followup questions you may have!

Name(Required)

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Phone(Required)

Is this for a company/organization?(Required)

Yes, for a company or organization

No, for an individual

Company/organization name(Required)

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Address(Required)

Street Address Suite, apartment, or unit number City State / Province / Region ZIP / Postal Code Country

MiraColt™ product you'd like to reserve(Required)

MiraColt Base

MiraColt Plus

MiraColt Base – Rental

MiraColt Plus – Rental

MiraColt™ acquisition time frame(Required)

Within 1 Month

1 to 3 Months

3 to 6 Months

Greater than 6 Months

Would you like to discuss financing options for your MiraColt™ Purchase(Required)

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The MiraColt™ is currently serving….

39

PATH or AHA Affiliated Centers

23

In Homes for Personal Use

17

PT, OT & SLP Centers or Clinics

3

Senior Care Facilities or Communities

8

Special Education Facilities

11

Higher Ed. & Research Centers