This medical ID Reel comes embellished with coordinating beads(may vary slightly) and name/title of choice. (2-4 letters behind the name works best). It also comes with a caduceus charm. Title can change so please make sure to leave all wording at checkout (including name and title needed-please verify if RN remains). The pull is approximately 33 inches in length. (The image size is roughly 1 inch). The bezel is protected with a water resistant sealant (not water proof). Please Note: The color intensity of the beads/image may vary slightly from what is shown due to computer monitor settings and bead availability. Please view policies for more info. Thank you for shopping at Sugar Tree and Company. All material is copyright © 2010 Sugar Tree and Company. All Rights Reserved.