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Order Form

Practice and Clinicians order form

Order form for the EarWell Infant Ear Correction System Starter Kit

A doctor’s medical registration number can be found at the Ahpra website https://www.ahpra.gov.au/Registration/Registers-of-Practitioners#; it will start with MED000
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Before you order

EarWell kits contain single-use components and cannot be returned or exchanged once opened. We do not offer refunds for change of mind or incorrect product selection. If you are unsure which kit suits your patient population, please contact us before ordering. Full details are set out in our returns and exchanges policy. Nothing in this policy limits your rights under the Australian Consumer Law.