How to place an order: All products available on Photonwave.be are only sold to therapists. By completing this form, you declare being a therapist using Photonwave for professional purposes. If your application is accepted, within 48 hours after placing the order, you will receive an email with your invoice and payment invitation. Orderform TitleEnter your name* First Last Profession*ClinicVAT number (if applicable)Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email* Phone*Website If you don't have a website, use this field to submit some other kind of online reference to your activities.How did you find us (via whom / which channel)?Order selection PhotonWave (Excl. 21% VAT) Price: 4.950,00 € Campimeter/FCF Tester (Excl. 21% VAT) Price: 899,00 € For Shipping in the EU: Belgian VAT 21 %, will be added on your invoice. For shipping outside the EU: import taxes will have to be paid at the local customs.Select the item's you'd like to order* PhotonWave Campimeter Select your Shipping & Handling category*Every product has a different shipping & handling cost. If you buy both products, a reduction applies. Please make the right selection according to your checked order items.Shipping & Handling: PhotonWave ( + €150,00)Shipping & Handling: Campimeter ( + €100,00)Shipping & Handling: PhotonWave + Campimeter (+ €200,00)No shipping: I will pick up the product(s) myself at a seminar or in Belgium ( + €0,00) Important remark This is not a medical device, all users should consult a medical professional for any illness and get advice of a trained practitioner for any physical and psychological condition. Rainbow-Flash bvba is not responsible at any time for any misuse of the PhotonWave, Light stimulation. Light stimulation has been used worldwide for many decades. www.international-light-association.org www.collegeofsyntonicoptometry.com/home.html Rainbow-Flash b.v.b.a. Louis Van Campenhoutstraat 41 B - 2870 Liezele BELGIUM VAT Nr. BE 0552 522 886Tel: 0032/(0)4184.108.40.206 E-mail: email@example.com Web: www.photonwave.be What happens next By submitting this form, you agree to receive an invoice with a payment invitation. This is a manual process, please keep in mind that the invoice creation will not happen instantly. You will be contacted by mail. EmailThis field is for validation purposes and should be left unchanged.