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Patient Form Order Form

You may order below using a credit card via PayPal or send your order to:

    Eastern Digital Resources
    PO Box 1451
    Clearwater, SC 29822-1451
    (803) 439-2938
    EMAIL: Sales@ResearchOnLine.net

    Patient Form
    English / Creole - 100 copies.
    $7.00
    Patient Form
    English / Creole - 1000 copies.
    $50.00
    Patient Form
    English / Creole - 5000 copies.
    $200.00
    Patient Form
    French / Creole - 100 copies.
    $7.00
    Patient Form
    French / Creole - 1000 copies.
    $50.00
    Patient Form
    French / Creole - 5000 copies.
    $200.00
    Patient Form
    English / Spanish - 100 copies.
    $7.00
    Patient Form
    English / Spanish - 1000 copies.
    $50.00
    Patient Form
    English / Spanish - 5000 copies.
    $200.00
    Shipping via media mail is included within the U.S. Priority shipping is extra. Please contact us for international shipping rates.

    Dealer inquiries are welcome. Please contact us for details.


  © Copyright 2005 Eastern Digital Resources. All rights reserved.