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OFFER #1 OFFER #2
$300 end FREE NXT
user rebate Hg5 Upgrade
on an Offer*
Upgrade your Hg5
NXT Hg5 Amalgam Separator
Amalgam to the new NXT Hg5
Amalgam Separator
Separator for FREE! Get an
entire new system
Practice Waste Solutions & restart your
Amalgam Bucket included! 2-year warranty
Item# Description Suggested Retail Item# Description Promo Price
NXT-HG5-001 NXT Hg5 Amalgam Separator $860.00 NXT-HG5-RPL2 NXT Hg5 Amalgam Separator $0.00
NXT-HG5-MINI NXT Hg5 mini Amalgam Separator $860.00 NXTMINI-RPL2 NXT Hg5 mini Amalgam Separator $0.00
NXT-HG5-HV NXT Hg5 High Volume Amalgam Separator $2860.00 *Current customers only. Serial number of current Hg5 Separator required.
Form must be completed to process your rebate. Rebates require enrollment in the Solmetex Auto-
Ship program. Dealer invoice must be submitted along with this rebate form for processing.
Doctor name: ____________________________ Practice name: ________________________________
Address: _____________________________________________________________________________
City: ____________________________ State: __________________________ Zip code: ____________
Phone: _________________________________ Fax: _________________________________________
E-mail: ______________________________________ Dealer: __________________________________
OFFER #1 ONLY: Serial No. of NXT Hg5 Amalgam Separator (Example “NXTHG5-K-12345”) required:
NXTHG5-____-____ ____ ____ ____ ____ Invoice No.: _________________________________
(Rebate will not be processed without the serial number which is located on the upper chamber of the NXT Hg5 Amalgam Separator)