|
Name_____________________________________________________
Address___________________________________________________
City/State/Zip_______________________________________________
Phone_____________________________
Email Address
(required)____________________________________________
User Name (No institutional or company names
allowed)____________________________________________________
Method of Payment [ ] Check (payable to Hand Medical)
[ ] MasterCard [ ] Visa [ ]
AMEX
Credit Card # ____________________________ Expiration
date __________________
Signature _______________________________________________
Platforms Desired (Check one in each category)
Desktop [ ] Windows PC
[ ] MAC
Handheld [ ] Palm OS
[ ]
Pocket PC
All software is available
for either Palm OS or Pocket PC OS unless othewise stated.
|
Product
Name
|
Code
|
Quantity
Ordered
|
Unit
Price
|
Total
Price
|
|
Anticoagulation
Manager
|
COAG
|
|
$69.95
|
|
|
Clozapine Manager
|
CLOZ
|
|
$29.95
|
|
|
Dental Lexi-Drugs
(for Palm OS only) (*)
|
LEXIDENT
|
|
$75.00
|
|
|
Depression
Manager
|
DEP
|
|
$49.95
|
|
|
Drug Regimen
Review Manager
|
DRR
|
|
$139.95
|
|
|
Gero-Psychiatry
Manager
|
GPSY
|
|
$99.95
|
|
|
HanDBase
|
HAND
|
|
$24.99
|
|
|
Lexi-Drugs
Platinum (for Palm OS only) (*)
|
LEXIPLAT
|
|
$75.00
|
|
|
Lexi-Interact
(for Palm OS only)
|
LEXINT
|
|
$75.00*
|
|
|
Lexi-Natural
Products (for Palm OS only)
|
LEXINAT
|
|
$75.00*
|
|
|
Medication Usage
Evaluation Manager with Infectious Disease database
|
MUE-ID
|
|
$269.95
|
|
|
Medication Usage
Evaluation Manager with Long Term Care database
|
MUE-LTC
|
|
$269.95
|
|
|
Medication Usage
Evaluation Manager with Hospital database
|
MUE-HOSP
|
|
$269.95
|
|
|
Medication Usage
Evaluation Manager with Psychiatry database
|
MUE-PSYCH
|
|
$269.95
|
|
|
Med Pass Manager
|
PASS
|
|
$49.95
|
|
|
Memory Manager
|
MEM
|
|
$49.95
|
|
|
Nursing
Lexi-Drugs (*)
|
LEXIRN
|
|
$75.00
|
|
|
Patient Hand
Chart
|
PHC
|
|
$139.95
|
|
|
Pediatric
Lexi-Drugs (*)
|
LEXIPED
|
|
$75.00
|
|
|
Pharmaceutical
Care Manager
|
PCARE
|
|
$139.95
|
|
|
PrioriMed
|
PRIMED
|
|
$49.95
|
|
|
Senior Health
Risk Assessor
|
SRA
|
|
$169.95
|
|
|
Urinary
Incontinence Manager
|
UI
|
|
$49.95
|
|
|
Wound Care
Manager
|
WC
|
|
$495.95
|
|
|
|
|
|
|
|
|
Device:
|
|
|
|
|
|
Shipping/Handling (if product is shipped)
|
|
|
|
|
|
Order Total
|
|
|
|
|
|
Tax if in Massachusetts
|
5%
|
|
|
|
|
Grand Total
|
|
|
|
|
* This product is only $40.00 if ordered with a Lexi-Comp drug database
with the following code mark (*).
|
