Use this form to place your order if you want to pay by business check or PayPal instead of credit or debit card.  We do not accept personal checks.  We will email you an invoice with a total amount, an address to mail a check, and a link for paying online with PayPal or Credit Card.  This email will take up to 24 hours to arrive, if you are in a hurry we suggest purchasing here with a credit/debit card. 

You will also receive an email asking if you would like to be added to our mailing list, feel free to ignore it! However, we do use this for updates with important news about SAMi including software updates.

Name *
Name
Shipping Address *
Shipping Address
Product (Use Special Instructions below if ordering multiple) *
Tell us anything we need to know, such as if you want expedited shipping or multiple products.
IMPORTANT! READ THIS FIRST! SAMi is a nocturnal movement monitor and will detect all types of movement regardless of the movement’s origin. HiPass Design LLC does not guarantee the effectiveness of SAMi for any particular application and use of SAMi is solely at your own risk. SAMi has not been evaluated or approved by the U.S. Food and Drug Administration or any other government agency for any purpose. SAMi is not a medical device and is not intended for use in the prevention, diagnosis, mitigation, treatment, or cure of any disease or other conditions. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. *
Please check box to indicate your acceptance of these terms of sale.
How did you hear about us? (optional)