Business Name *

What is your first & last name *

What is the phone number associated with your AR account? *

What email is associated with your AR account? *

What is your shipping address? (address, city, state, and zip) *

Which reader would you like to purchase?

Please note: bluetooth readers will pair with iphone/ipad or iMac devices with M2 chip only. Wifi readers will pair with any device. Both Wifi readers has signature pad capabilities.

How many card readers would you like to order? Please note, the number selected here is in reference to the reader you selected on the previous page. Enter the quantity:

Shipping Costs: $13 per card reader; $22-$30 for 3 or more

Would you like to add any accessories for your reader? Please note that if you’re purchasing only an add-on, an additional shipping fee will apply.

How many of this add-on would you like to order? Please note, the number selected here is in reference to the add-on you selected on the previous page. Enter the add-on name and quantity.

By completing this form, you agree to pay for the card reader, we will charge the card on file for your reader. *

I agree, you can charge the card on file for my Aesthetic Record Subscription

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.