Mail Order Form
Please Fill Out This Form Completely Before Printing and Mail to
D & A Marketing, P.O. Box 336, Brentwood Bay, BC, V8M 1R3, Canada.


If you choose to fill it out by hand PLEASE PRINT LEGIBLY. If we cannot read the form we cannot process the order.
All prices are in US Funds and are subject to applicable taxes, shipping and duty. Services and prices subject to change without notice. *Any order above $500.00 get 10% discount.

Subject

Price

Quantity

Total

Teaching Cards

Predialysis: A Discussion of Uremia and Treatment Options

$39.95

Common medications *

$44.95

Diet consideration:

$39.95

Laboratory results

$39.95

Hemodialysis

$39.95

Peritoneal dialysis

$39.95

Calcium, Phosphorous and Vitamin D Connection+

$29.95

Posters

Basic Concepts      
Dry or Goal Weight

$14.95

Principles of dialysis

$14.95

Anatomy of Renal System

$14.95

Normal Renal Function

$14.95

Symptoms of Uraemia

$14.95

Warning signs of kidney disease

$14.95

Treatment Options - Comparison between Hemodialysis and Peritoneal Dialysis

$24.95

Core Indicators and Medications      
Dialysis Adequacy

$14.95

Anemia Management

$14.95

Calcium, Phosphorous + Vitamin D Connection

$14.95

Blood Pressure Control in Renal Failure

$14.95

Medications in Renal Failure $14.95
Diet Related Posters      
Potassium level in foods $17.95
Phosphorus level in foods $17.95
The Renal Diet - An Overview $24.95
Dialysis Access      
Hemodialysis Access $14.95
Peritoneal Dialysis Access $14.95
Hemodialysis Catheters $14.95
Predialysis Package      
Predialysis Package: The predialysis package includes one set of laminated cards and 6 posters. $129.95
The Hemodialysis package includes three set of laminated cards and four posters: $169.95
The Peritoneal Dialysis package includes three set of laminated cards and three posters $159.95

1. Fill In Your Personal Customer Information: ( SHIP TO: )

Full Name:
Address:
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2. Choose a payment Method: Visa Master card Check Money Order
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3. PURCHASE ORDERS ONLY

NOTE :
This section is for PURCHASE ORDERS ONLY.

Payment via :
Purchase Order Number:

4. Choose a Shipping Method:

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4. Fill In the Totals:  
Total Amount for Teaching Cards and/or Posters:
Total Amount For Shipping:
TOTAL ENCLOSED:

Please sign here: _________________________________
Please fax this form to 1-250 544-3117 (24 hours a day, 7 days a week) or

5. Mail to:
If you're paying by mail:

  • Do not staple your cheque or money order
  • Do not send cash through the mail
  • Please make your cheque or money order payable to D & A Marketing.

Mail your cheque or money order to:

D & A Marketing, P.O. Box 336, Brentwood Bay, BC, V8M 1R3, Canada.

*If you are ordering on behalf of a Hospital or Organization a purchase order can be accepted and an invoice will be sent out.

Thank you very much for placing your order with us. *Please see the different rates when the orders are beyond.