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HomEx Fax Order Form For Practice Transcription Tapes & CDs

Practice Your Transcription: Real Physician Dictation: Main Page ~ Cardiology ~ ESL Internal Medicine ~ Family Medicine ~ Gastroenterology ~ General Surgery ~ Neurology ~ Otolaryngology ~ Radiology ~ Single Tapes Menu ~ Urology Special: Private Label CDs For Medical Transcription Schools ~ WAVpedal & CD-ROM Internet Bundle ~ Complete 3 CD-ROM Disk Set of 9 Specialties ~ One 16-Tape Set Standard or Micro ~ Single CD-ROM Specialty Combination Sets ~ Three 2-Tape Sets Other: Dictation Tape Facts ~ FAQs ~ Return Policy ~ Tape Tips ~ Download Audio Samples ~ Download Free eBooks

Please complete this form & print it, then mail or fax to the address below.

Name______________________________________________

Company___________________________________________

Street Address_______________________________________

City, State, Zip ______________________________________

Phone: ______________________

E-mail (to confirm order only): _____________

ITEM DESCRIPTION: (For dictation orders please be sure to included your preferred media format, i.e. standard or micro tapes, or CD-ROMs.)

Item Details: _______________________________________ Price $_______

Item Details: _______________________________________ Price $_______

Any Details Needed For Order Fulfillment? ___________________________________________________________

___________________________________________________________

SHIPPING FEES: Any Complete Set and Transcript Keys $15. Any Individual Set or Single CD-ROM and Transcript Keys $7.00.
We ship via USPS Priority Mail with Delivery Confirmation.

Your Shipping Fee: $______
GRAND TOTAL: (US dollars only)$____________

PAYMENT OPTIONS: Enclose Check or Money Order with this form via mail, OR Charge to (Circle one) Visa / MasterCard / Discover and mail.

Cardholder Name_____________________________________

Account No. _________________________________________

Expiration Date ___________________

Authorized Signature_______________________________________________

*Please make checks payable to our supplier directly:
HomEx Medical, NOT Medword.
Mail your order to:
HomEx Medical
P.O. Box 637
Hampstead, Maryland 21074

We will confirm receipt of your order via e-mail. Every effort is made to ship within 5 working days of receipt of your order.

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HomEx Fax Order Form