PLACE AN ORDER

Fill out the following form to Place An Order with Nexsis Biosciences.
* All items with a red asterisk are required fields.

CUSTOMER NAME

CUSTOMER ACCOUNT NUMBER

P.O. NUMBER

DATE

This order is subject to the Terms and Conditions.

CUSTOMER AUTHORIZATION

TITLE

PHONE

CUSTOMER AUTHORIZATION SIGNATURE

REQUESTED DATE

PRODUCTS

Dural

NXDUR0203

Durasis Dural Graft 2x3 cm

1 ea.

NXDUR0203

Dural

NXDUR0407

Durasis Dural Graft 4x7 cm

1 ea.

NXDUR0407

Dural

NXDUR0710

Durasis Dural Graft 7x10 cm

1 ea.

NXDUR0710

Dural

NXDUR0720

Durasis Dural Graft 7x20 cm

1 ea.

NXDUR0720

*Nexsis Durasis is the exact same product as the previously supplied Cook Biotech's Biodesign® Dural Graft
+Cook Biotech's Biodesign® Dural Graft part numbers will be replaced by Nexsis Durasis part numbers effective August 1, 2025.