BioCellara

Platinum Biologics Order

Platinum Biologics order form

For qualified provider accounts. Complete the order below; BioCellara will send the completed Platinum order form to Platinum Biologics.

Account information Physician name NPI / account number Physician email Physician phone

Shipping information Clinic name Street address City

State ZIP code

Products

Product	Size	Price	Line total
Nano PRP Jelly	3 ml / 70mg	$150	$0
Nano Flex	1 ml / 150mg	$561	$0
Nano Flex	2 ml / 300mg	$761	$0
Nano Flow	1 ml	$711	$0
Nano Flow	2 ml	$1,061	$0
Nano Xsomes	180 Billion/ml	$1,250	$0
Nano AER	50 Billion	$500	$0
Nano AER Plus	90 Billion	$750	$0
Nano EX (topical only)	30 Billion	$250	$0
Nano DPM	95mg	$300	$0

Shipping method

Estimated total: $0

Confirm the required shipping method and current pricing before submitting. Orders are confirmed by Platinum before shipment.

Order contact Requested arrival date Account Manager Rep name Distributor name

Billing address Same as shipping

Card number, expiration, and security code are not collected here. BioCellara or Platinum will arrange payment separately.

Platinum requests orders before 3:00 p.m. Eastern for same-day shipment, with shipments Monday–Thursday. Arrival dates are requests, not guarantees.