Upon receiving your order, an HES representative will contact you within two business days for payment. Once payment is received, we will mail your order to the address provided. Phonak Hearing Aid Supplies Order Form: Name * Address * City* State* Zip * Phone* Email Please Select: Wax Filters YesNo Number of Packs (6-8 filters per pack)? 1234 Domes YesNo Number of Packs (10 domes per pack)? 1234 Other: YesNo If other, please explain:   Δ