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2008 Patient Education Order Form III

Fill in the on-line order form here, click the send button and one of our staff members will contact you for your confidential credit card details - Bankcard, Mastercard, Visa and Amex cards are accepted.


OR


doc 2008 Patient Education Order Form July 145.00 Kb

 

pdf 2008 Patient Education Order Form July 63.66 Kb
 

Download the Order form Word Doc or Order form PDF and complete, then mail or fax it with a cheque, money order or credit card details to The Australian Lung Foundation.


All cheques/money orders to be made payable to "The Australian Lung Foundation".

Postal Address:
The Australian Lung Foundation,
PO Box 847,
Lutwyche QLD 4030
Fax: 07 3357 6988

Hospital & Community Health Centre Customers Please Note:

When ordering Patient Information Leaflets, an official order/purchase number from your purchasing department is sufficient. Your leaflets will be forwarded to you together with an ALF invoice.

Freight charges:

All leaflets are sent either Express Post or by courier, depending on the quantity of leaflets ordered.

The pricing structure is detailed below:
Less than 1-50 leaflets = $8.50
51-280 leaflets = $12.50
Greater than 280 leaflets = cost of courier plus $2.50 handling fee

On-line order form

Please send me the following ALF Patient Information Leaflets:

Name of Organisation:
required field
Contact Person:
required field
Delivery Address:
required field
Suburb/Town
required field
State
required field
Postcode
required field
Order Number (Hospital Customers Only):
Fax:
required field
Phone:
required field
My email address:
 
Customers from outside Australia

An additional charge for international postage will be added to the cost of your leaflet order. This will depend on the weight of the parcel, the destination and the mail service you require.

Please select your preferred mailing option, and we will email you a quotation on the postage for your order.

Select your preferred mailing option
Air Mail

Economy Air

Sea Mail
 
Title / Quantity Cost
Sub Total
Acute Bronchitis
45c each
Cost
Alpha-1-Antitrypsin Deficiency & Lung Disease
45c each Cost
Asbestos Related Lung Diseases
45c each Cost
Better Living with COPD
45c each Cost
Bronchiectasis
45c each Cost
Bronchoscopy
45c each Cost
COPD: Chronic Bronchitis & Emphysema
45c each Cost
The Common Cold
45c each Cost
Corticosteroid Therapy
Currently unavailable
   
Home Oxygen Treatment
45c each Cost
Influenza
45c each Cost
Interstitial Lung Disease - Adult
(NEW)
45c each Cost

Interstitial Lung Disease - Paediatric
(NEW)
45c each Cost

Lung Transplantation
45c each Cost
Obstructive Sleep Apnoea
45c each Cost
Sarcoidosis
45c each Cost
Silica Related Lung Disease
Currently unavailable
   
The Lungs
45c each Cost
Tuberculosis
45c each Cost
Special Edition LungNet News COPD
75c each
Cost
Sleep Apnoea Booklet Version 3
$5.00 each
Cost
Sail On CD
TBC Cost
Freight
Less than 1-50 leaflets = $8.50
51-280 leaflets = $12.50
Greater than 280 leaflets = cost of courier plus $2.50 handling fee (add any free leaflets for total numbers).
  Freight Cost
TOTAL
(please note freight charges will be added to your order)
  Total Payment Due

The following leaflets are available free of charge in reasonable quantities    
ALF Information Brochure
   
Quality of Life Through Patient Support
   
How to start a LungNet Support Group
   
Answering your Question about Lung Cancer
   
LungNet Can Help
   
 
required field = Required