Breast pump supplies form 

TENS Unit and supplies form 

This is form application designed to our patient ordering equipment in our website. This is a secure form so your information cannot be viewed elsewhere. If information is left out it will delay the delivery. We are committed to shipping your orders as soon as possible and the more complete the form, the better we are able to do so. Please feel free to give us a call:

Hawaii @808-722-0226, and Colorado@719-638-4056,

We've got your back!

Cant find what you need? Get in touch with a friendly member of our team. 

Doris M. CEO


Local  office Asst. Mngr.


Patient Support Spc.

Claims Dept.


Patient  Support Spc.

Medical Admin

Jeazel A.

Local Office Mngr.

Darcy R.

Patient Support Spc.

Medical Admin.

Colorado Corporate office

Phone: 719-638-4056

Fax: 719-638-4080


Hawaii Distribution Center 

Phone: 808-722-0226

Fax: 808-200-0391


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We accept all major credit cards for payment

       TENS Unlimited Inc.           tensunlimitedbreastpumps