Product Order Form

To order our products please fill out the information below OR print the following page and FAX or MAIL it to Infusion Knowledge, Inc. Please contact us if you have any questions or comments. Thank you!

Your e-mail address:

Your name:

Your Address:

City

State

Zip

Employer

Department

Title

Home Phone

Work Phone

Professional Designation

What products would you like to order? CRNI Review Workbook: $65

Video: Venipuncture Techniques for Blood Draws (Corporate Rate): $125

Video: Venipuncture Techniques for Blood Draws (Individual Rate): $65

Video: Peripheral Catheter I.V. Placement (Corporate Rate): $125

Video: Peripheral Catheter I.V. Placement (Individual Rate): $65

Video: Implanted Venous Port Access (Corporate Rate): $125

Video: Implanted Venous Port Access (Individual Rate): $65

Gift Certificate: (circle one) $20 $50 $100

Total Items

Subtotal + $10 Shipping & Handling

Total:

PAYMENT METHOD ?

Please allow 2-3 weeks for delivery.

Return Policy

Infusion Knowledge must receive order cancellations in writing within 3 days of order placement. Order discrepancies or damaged goods must be reported to Infusion Knowledge within 1 week of receipt.