Hardin-Simmons University Master of Physician Assistant

  1. { binding displayValue, mode=oneTime }

Please select your required equipment kit and choose your stethoscope color below. Optional upgrades available.

Your kit will be available for pickup at school in September!

ORDERS MUST BE SUBMITTED BY AUGUST 19th, 2022.

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Required Hardin-Simmons PA Kit {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Kit Includes:

Riester EliteVue Otoscope/Ophthalmoscope Kit with Rechargeable Lithium-Ion Battery

Riester Insufflator Bulb

MDF® Classic Cardiology Stethoscope with Custom Hardin-Simmons PA Diaphragm

MDF® Bravata® Palm Aneroid Sphygmomanometer with Adult and Pediatric Cuffs

MDF® LUMiNiX® III Penlight with Pupil Gauge

MDF® Taylor Hammer

MDF® 128Hz Tuning Fork

MDF® 512Hz Tuning Fork

Rosenbaum Eye Chart

Tape Measure

Monofilament (Not Pictured)

{ binding firstError.message }

Optional Upgrades:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

{# pageNumbers}
Will you be using financial aid funds when purchasing your equipment? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Students using financial aid will not be charged until the date designated.

{ binding firstError.message }
Name on card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Billing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

{~ Payment_Block_Label}

{ binding firstError.message }
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}
{# pageNumbers}

Hardin-Simmons University Master of Physician Assistant

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding PhoneNumber}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

Please select your required equipment kit and choose your stethoscope color below. Optional upgrades available.

Your kit will be available for pickup at school in September!

ORDERS MUST BE SUBMITTED BY AUGUST 19th, 2022.

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Required Hardin-Simmons PA Kit {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Kit Includes:

Riester EliteVue Otoscope/Ophthalmoscope Kit with Rechargeable Lithium-Ion Battery

Riester Insufflator Bulb

MDF® Classic Cardiology Stethoscope with Custom Hardin-Simmons PA Diaphragm

MDF® Bravata® Palm Aneroid Sphygmomanometer with Adult and Pediatric Cuffs

MDF® LUMiNiX® III Penlight with Pupil Gauge

MDF® Taylor Hammer

MDF® 128Hz Tuning Fork

MDF® 512Hz Tuning Fork

Rosenbaum Eye Chart

Tape Measure

Monofilament (Not Pictured)

Choose your stethoscope color: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Optional Upgrades:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Will you be using financial aid funds when purchasing your equipment? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date financial funds can be charged {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Name on card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Billing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
I authorize MDF Instruments to charge my credit card for the authorized amount. I understand that my information may be saved and charged at a later date if I use student loan funds for this purchase. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date of Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Hardin-Simmons University Master of Physician Assistant

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding PhoneNumber}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

Please select your required equipment kit and choose your stethoscope color below. Optional upgrades available.

Your kit will be available for pickup at school in September!

ORDERS MUST BE SUBMITTED BY AUGUST 19th, 2022.

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Required Hardin-Simmons PA Kit {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Kit Includes:

Riester EliteVue Otoscope/Ophthalmoscope Kit with Rechargeable Lithium-Ion Battery

Riester Insufflator Bulb

MDF® Classic Cardiology Stethoscope with Custom Hardin-Simmons PA Diaphragm

MDF® Bravata® Palm Aneroid Sphygmomanometer with Adult and Pediatric Cuffs

MDF® LUMiNiX® III Penlight with Pupil Gauge

MDF® Taylor Hammer

MDF® 128Hz Tuning Fork

MDF® 512Hz Tuning Fork

Rosenbaum Eye Chart

Tape Measure

Monofilament (Not Pictured)

Choose your stethoscope color: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Optional Upgrades:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Will you be using financial aid funds when purchasing your equipment? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date financial funds can be charged {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Name on card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Billing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
I authorize MDF Instruments to charge my credit card for the authorized amount. I understand that my information may be saved and charged at a later date if I use student loan funds for this purchase. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date of Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }