Purchase Quotation/Invoice Order Form

Although we prefer payment be made online by credit card, we recognize that sometimes that's not possible. Therefore, we do our best to accommodate invoice-based payments for larger orders/organizations. We accept PQ/Invoice Orders from only companies/organizations.

  • Note to Students Ordering Manuals for a Class: Small-quantity student manual orders must utilize our credit card order form.

Important note to purchasers outside of the United States (international buyers): We currently accept only credit card purchases from outside of the United States.

If you would like to purchase any of our products and pay by check, please contact us using the form below. Following receipt of your order form, a Purchase Quotation (referencing the provided RFQ/Reference Number) and Invoice (following receipt of a Purchase Order Number) will be sent to the emails listed in the form. See important payment/delivery terms below. For immediate processing and fastest delivery/shipment of program materials and manuals, please use our credit card-based ordering forms.

Important PO/Invoice Payment and Delivery Terms:

  • Payment is due immediately upon receipt of emailed invoice and late after 30 days.

  • Program materials are not sent until payment has been received and processed.

  • We currently accept only credit card purchases from outside of the United States.


Name *
Name
Address *
Address
Phone *
Phone
Accounts Payable Contact Name *
Accounts Payable Contact Name
Accounts Payable Contact Phone Number *
Accounts Payable Contact Phone Number
Are you a tax-exempt provider, organization or facility? *
Please provide Tax Exempt ID Number below or send proof of tax exemption status to cope.dyork@gmail.com and reference this order.
Ship to Name *
Ship to Name
Ship to Address *
Ship to Address
Ship to Phone *
Ship to Phone
Stand-Alone Products
Please indicate the quantity of each product in the box below.
Each stand-alone program purchase includes five student manual/workbooks. Please indicate below which manuals you would like to have included with your order.
Schools - Transitional Event Program Packages
Please indicate the quantity of each product in the box below.
Medical Professionals - Introductory Discounted Program Packages
Please indicate the quantity of each program in the box below.