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EQUIA® Forte
Bulk Fill, Fluoride Releasing, Glass Hybrid Restorative System

Order Form
Shopping Cart & Customer Information

   

Please complete the Shopping Cart and Customer Information Forms to submit your order.
An Inside Sales Representative from GC America will contact you to confirm your free goods.

United States Section (this section is required for United States Orders ONLY)

Shopping Cart Information
Item Number Description Quantity
452005 EQUIA Forte - Intro Kit Assorted Shades
Contains: EQUIA Forte Fil (10 caps of each shade: A2, A3 and A3.5; 9 caps of each shade: B1 and B3; 0.14 mL liquid per capsule), EQUIA Forte Coat bottle (4 mL) and GC CAVITY CONDITIONER bottle (5.7 mL).
452001 EQUIA Forte - Intro Kit Shade A1 (48)
452002 EQUIA Forte - Intro Kit Shade A2 (48)
452003 EQUIA Forte - Intro Kit Shade A3 (48)
452004 EQUIA Forte - Intro Kit Shade A3.5 (48)
452006 EQUIA Forte - Intro Kit Shade B1 (48)
452007 EQUIA Forte - Intro Kit Shade B2 (48)
452008 EQUIA Forte - Intro Kit Shade B3 (48)
452009 EQUIA Forte - Intro Kit Shade C4 (48)
452500 EQUIA Forte Coat - Refill (Bottle)
Contains: One EQUIA Forte Coat bottle (4 mL), 50 Micro-Tip Applicators, 1 Applicator Holder and 20 Disposable Dispensing Dishes.
452505 EQUIA Forte Coat - Refill (NEW!  Unit Dose)
Contains: Box of 50 EQUIA Forte Coat Unit Doses (0.1 mL each), 50 Micro-Tip Applicators and 1 Applicator Holder.
452000 EQUIA Forte Fil - Assorted Shades
Contains: Ten caps of each shade: A2, A3 and A3.5; 9 caps of each shade: B1 and B3; 0.14 mL liquid per capsule.
452010 EQUIA Forte Fil - Shade A1 (48)
452011 EQUIA Forte Fil - Shade A2 (48)
452012 EQUIA Forte Fil - Shade A3 (48)
452013 EQUIA Forte Fil - Shade A3.5 (48)
452014 EQUIA Forte Fil - Shade B1 (48)
452015 EQUIA Forte Fil - Shade B2 (48)
452016 EQUIA Forte Fil - Shade B3 (48)
452017 EQUIA Forte Fil - Shade C4 (48)


Canadian Section (this section is required for Canadian Orders ONLY)

Shopping Cart Information
Item Number Description Quantity
462005 EQUIA Forte - Intro Kit Assorted Shades
Contains: EQUIA Forte Fil (10 caps of each shade: A2, A3 and A3.5; 9 caps of each shade: B1 and B3; 0.14 mL liquid per capsule), EQUIA Forte Coat bottle (4 mL) and GC CAVITY CONDITIONER bottle (5.7 mL).
462001 EQUIA Forte - Intro Kit Shade A1 (48)
462002 EQUIA Forte - Intro Kit Shade A2 (48)
462003 EQUIA Forte - Intro Kit Shade A3 (48)
462004 EQUIA Forte - Intro Kit Shade A3.5 (48)
462006 EQUIA Forte - Intro Kit Shade B1 (48)
462007 EQUIA Forte - Intro Kit Shade B2 (48)
462008 EQUIA Forte - Intro Kit Shade B3 (48)
462009 EQUIA Forte - Intro Kit Shade C4 (48)
452500 EQUIA Forte Coat - Refill (Bottle)
Contains: One EQUIA Forte Coat bottle (4 mL), 50 Micro-Tip Applicators, 1 Applicator Holder and 20 Disposable Dispensing Dishes.
452505 EQUIA Forte Coat - Refill (NEW!  Unit Dose)
Contains: Box of 50 EQUIA Forte Coat Unit Doses (0.1 mL each), 50 Micro-Tip Applicators and 1 Applicator Holder.
462000 EQUIA Forte Fil - Assorted Shades
Contains: Ten caps of each EQUIA Forte Fil Shade: A2, A3, A3.5, B1 and B3.
462010 EQUIA Forte Fil - Shade A1 (48)
462011 EQUIA Forte Fil - Shade A2 (48)
462012 EQUIA Forte Fil - Shade A3 (48)
462013 EQUIA Forte Fil - Shade A3.5 (48)
462014 EQUIA Forte Fil - Shade B1 (48)
462015 EQUIA Forte Fil - Shade B2 (48)
462016 EQUIA Forte Fil - Shade B3 (48)
462017 EQUIA Forte Fil - Shade C4 (48)


Customer Information
*Denotes required field
Salutation:
First Name:* *
Last Name:* *
Office Name:* *
Office Address:* *
Office Address 2:
City:* *
State/Province:* *
Zip Code:* *
Country:* *
E-mail Address:* *
Phone Number:* *
Fax Number:
Dealer:* *
Dealer Account Number:


To place an order for GC America Products, please click the "Submit" button (above). An Inside Sales Representative from GC America will call you to execute the placement of your order with an authorized GC Dealer. If you need to contact us, please call 800-323-7063.

Click here to learn more about EQUIA® Forte.

 

 
   
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