Order Form

Consumables Order Form

Please complete your practice and order quantity details below. This will be sent as an email to our Customer Service team, and will be processed as soon as possible. Please call us on 1300 657720 if you have any queries.

Name(*)

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Practice Name(*)

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Practice Address(*)

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Phone Number(*)

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Email Address(*)

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PO#

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Lid Cleansing Wipes & Foams

Blephadex Pro with Manuka
30 Lid Wipes

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Blephadex Lid Wipes
30 Lid wipes

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Blephadex Foam
Lid Scrub 50ml

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Eye Lubricants

Xailin Hydrate
Hypromellose 0.3% 10 ml bottle

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Xailin FRESH
Carmellose Na 0.5% 0.4 ml x 30

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Xailin GEL
Carbomer 0.2% tube

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Xailin NIGHT
White Soft Paraffin 5g

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ALL ITEMS THAT REQUIRE COLD SHIPMENT WILL AUTOMATICALLY BE SHIPPED IN OUR COOL PACK SYSTEM (REQUIRED BY LAW) AND WILL INCUR A COLD SHIPMENT COST . 
NO COLD SHIPMENTS WILL OCCUR ON A FRIDAY OR THE DAY BEFORE A PUBLIC HOLIDAY.

Please insert desired quantities in space provided. To see a more detailed explanation of these goods please download our pharmaceuticals listing available in the product menu.

Mydriatics and Cycloplegics

Atropine 1%

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Cyclopentolate 0.5%

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Cyclopentolate1.0%

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Phenylephrine 2.5%

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Phenylephrine 10%

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Tropicamide 0.5%

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Tropicamide 1.0%

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Mydriacyl 0.5%

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Mydriacyl 1.0%

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Cyclogyl 1.0%

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Pilocarpine 2%

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Local Anaesthetics & Stains

Amethocaine 0.5%

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Amethocaine 1.0%

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Oxybuprocaine0.4%

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Alcaine

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Lignocaine 4% Fluorescein 0.25%

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Fluorescein 1%

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Fluorescein 2%

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Antibacterials & Corticosteroids

Chloramphenicol

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Prednisolone 0.5%

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Diagnostic Strips

Optistrips FL 100 Fluorescein Strips

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Optistrips FL 300 Fluorescein Strips

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Schirmer Tear Test with Blue Mark

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Rose Bengal

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Alcohol Swabs

Medical Swabs 200 alcohol swabs

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ISO Wipes Canister (75)

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Personal PPE

Face Masks
Level 2 (50)

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Face Mask
level 1 (20) -general

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Protective Gloves (M) -100

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Eyelid Debridement

Blephex Tips
Tips for Blephex device(20)

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Blephadex Applicators debridement (20)

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Miscellaneous

26g lacrimal cannula
(curved) box of 10

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5ml slip tip syringe
100

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3ml syringe
100

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Alger Brush Burr
choose packet tip size
reusable

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Anything Else You Would Like?

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please request in box

Validate before submitting(*)

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Diagnostic & Medical

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Lens Edging & Dispensing

Lists and Details

Consumables Order Form

Lid Cleansing Wipes & Foams

Mydriatics and Cycloplegics

Local Anaesthetics & Stains

Antibacterials & Corticosteroids

Alcohol Swabs

Personal PPE

Eyelid Debridement

Miscellaneous

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