SMART eXo Order Form

Physician’s name as it appears on the Medical License

Medical License Number

Physician’s NPI Number

Shipping Address

Shipping City, State and ZIP

Contact Phone Number

SMART eXo PURE - 4 mL (2 units/pack) @ $395.00/pack

SMART eXo GENESIS - 4 mL (2 units/pack) @ $495.00/pack

Shipping Options

Next Day Air – Estimated Delivery 10:30 AM - 12:00 PM next day @ $125

Next Day Air Early – Estimated Delivery by 8:30 AM next day @ $225

***PLEASE NOTE: Due to UPS operations, the delivery times are now estimates only. SmartSolutions RX CANNOT guarantee UPS estimated delivery times and highly recommends all orders be placed at least two (2) days prior to scheduled treatment date to allow for delays. Smart Solutions RX freezer packs are validated for 48 hours to stay cold. To extend storage, packages should be placed in freezer as soon as received or immediately used. Smart Solutions RX will not be responsible for any associated cost of product refund or delays when deliveries are scheduled for same day as treatment.

Any questions: lacomedical@gmail.com>, (440) 840-4537

SMART eXo Products

• SMART eXo PURE: 4 mL (2 units/pack) $395.00/pack

• SMART eXo GENESIS: 4 mL (2 units/pack) $495.00/pack

SMART eXo Order Form

Any questions: lacomedical@gmail.com>, (440) 840-4537

SMART eXo Products​

​​​​​

SMART eXo Products