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Punctal Plug
Product Order

Punctal Plug Product Order – US CUSTOMERS ONLY

NEW CUSTOMERS: Please fill out one of our required account applications: Net 30 Terms or Credit Card Only. You will be contacted by our Customer Service team within 24-48 hours with information on your new account. You must have an active account to order, regardless of payment type.

RETURNING CUSTOMERS: Please fill out the punctal plug order request below, and your order will be processed within 24 hours. You will receive an order confirmation and invoice once your order has been processed.

Product pricing, taxes and shipping/handling charges will be reflected on your order confirmation and invoice. For questions regarding pricing, please contact our Customer Service team at 866-906-8080 or

For urgent orders or inquiries, please contact Customer Service at 866-906-8080 for assistance

INTERNATIONAL CUSTOMERS: Please contact Customer Service for additional ordering information

Punctal Plug Order Request

* = Required Field

First Name *:
Last Name *:
E-mail Address *:
Phone Number *:
Facility/Account Name *:
Address *:
City *:
State *:
Postal/Zip Code *:
PO# or Date *:
Account Number:
Additional Notes:

Parasol (Permanent Occlusion)

Item # Description Order Qty
A14-200 X-Small Pre-Loaded (1 pair)
A14-201 Small Pre-Loaded (1 pair)
A14-202 Medium Pre-Loaded (1 pair)
A14-203 Large Pre-Loaded (1 pair)
A14-201QL Small Quickload (8 pairs)
A14-202QL Medium Quickload (8 pairs)
A14-203QL Large Quickload (8 pairs)
A14-205QL Combo Quickload (8 pairs)
A14-201BN Small Bulk Non-Sterile (10 pairs)
A14-202BN Medium Bulk Non-Sterile (10 pairs)
A14-203BN Large Bulk Non-Sterile (10 pairs)
A14-209BN Combo Bulk Non-Sterile (10 pairs)

Extend (Mid-Term Occlusion)

Item # Description Order Qty
A13-202 .2 mm (10 pairs)
A13-203 .3 mm (10 pairs)
A13-204 .4 mm (10 pairs)
A13-205 .5 mm (10 pairs)
A13-200 Variety Pack (10 pairs)

Collagen (Short-Term Occlusion)

Item # Description Order Qty
A12-102 .2 mm (60 implants)
A12-103 .3 mm (60 implants)
A12-104 .4 mm (60 implants)
A12-200 Variety Pack (60 implants)

Micro Flow (Partial Occlusion)

Item # Description Order Qty
A14-401 Small Pre-Loaded (1 pair)
A14-402 Medium Pre-Loaded (1 pair)
A14-403 Large Pre-Loaded (1 pair)
A20-401BN Small Bulk Non-Sterile (5 pairs)
A20-402BN Medium Bulk Non-Sterile (5 pairs)
A20-403BN Large Bulk Non-Sterile (5 pairs)

Plus (Permanent Occlusion)

Item # Description Order Qty
A14-204 Small Pre-Loaded (1 pair)
A14-205 Medium Pre-Loaded (1 pair)
A14-206 Large Pre-Loaded (1 pair)
A14-207 X-Large Pre-Loaded (1 pair)
A14-204BN Small Bulk Non-Sterile (10 pairs)
A14-205BN Medium Bulk Non-Sterile (10 pairs)
A14-206BN Large Bulk Non-Sterile (10 pairs)
A14-207BN X-Large Bulk Non-Sterile (10 pairs)


Item # Description Order Qty
A14-300 Reusable Inserters (1 pair)
A14-302 Punctal Gauge/Dilator
3740 Jewelers Forceps
A10-100 Patient Brochures - English*
A10-101 Patient Brochures - Spanish*
WALLCHART Lacrimal Wall Chart

* Three packs free per order; additional packs cost $3.50/pack


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