2014 Order Form: PSA Member - Australian Medicines Handbook

SEND THIS ORDER FORM
BY FAX: 08 8313 6980 (Credit Card payment only)
BY MAIL: Australian Medicines Handbook
PO Box 240, Rundle Mall, South Australia 5000
ORDER ONLINE: www.amh.net.au (Credit Card payment only)
ORDER BY PHONE: 08 8313 6977 (Credit Card payment only)
2014 Order Form: PSA Member
PSA Price
(single item)
Add Postage &
Handling (single item)
AMH Book
$174.60
$16.00
AMH Download*
$174.60
–
AMH Online**
$174.60
–
AMH Mobile**
$174.60
–
AMH Online + Mobile**
$228.00
–
AMH Book + Download*
$266.80
$16.00
AMH Book + Online**
$266.80
$16.00
AMH Book + Mobile**
$266.80
$16.00
AMH Pharmacy Package***
$432.40
$16.00
AMH Pharmacy Package (FRED Integrated)***
$478.40
$16.00
AMH Children’s Dosing Companion**
$62.10
–
AMH Children’s Dosing Companion (Print)
$78.20
$9.00
AMH Aged Care Companion (Online)****
$50.60
–
AMH Aged Care Companion (Print)
$78.20
$9.00
ORDER DETAILS
All prices include GST
Quantity
Total Price
(inc P&H)
AMH Book + Electronic
*Single-user/12-month licence; includes one six-monthly update **Single-user/12-month licence; immediate access; includes content update each January and July
***Book + 3-Screen licence; access for 12 months for electronic version with content updated each January and July ****Single-user/12 month licence
PURCHASER DETAILS
Please complete all sections
TOTAL $
Electronic version purchasers MUST provide email address
Purchaser Name
Contact Name (if purchased
by organisation/company)
Title
Delivery Address
Postcode
Fax
Email Address
Daytime Phone
PSA Membership Number
Personal information will only be accessed and used for the primary purpose for which it is collected, and for purposes related or ancillary to the main reasons we collect it, such as invoicing, reminder notices and services offered by us. We engage third party contractors
to perform services for us which involve the contractor handling personal information we hold. We will take all reasonable steps to ensure that personal information is protected against loss, unauthorised access, modification or disclosure, and other misuse.
WHAT IS YOUR PROFESSION? (This information is for internal AMH use and will not be made available to any third party)
HOSPITAL MEDICAL
PRACTITIONER
COMMUNITY MEDICAL
PRACTITIONER
MEDICAL
STUDENT
PHARMACY
STUDENT
PAYMENT DETAILS
TOTAL AMOUNT
COMMUNITY
PHARMACIST
HOSPITAL
PHARMACIST
NURSE
PRACTITIONER
OTHER
(Please specify)
Full payment (Cheque/Money Order/Credit Card Details) MUST be included with Order
$
PAYMENT METHOD: Please tick applicable box CREDIT CARD
CREDIT CARD DETAILS
VISA
AMEX
MASTERCARD
CHEQUE/MONEY ORDER
(Send by post; make payable to
Australian Medicines Handbook)
NUMBER
NAME ON CARD
EXPIRY DATE
*For P&H charges on multiple items, please contact AMH on 08 8313 6977.
SIGNATURE
Book prices are for January 2014 edition. AMH Download/Online/Mobile subscriptions are for 12 months and commence from date order processed or at conclusion of existing subscriptions, with content updated each January and
July. Prices current from January 1, 2014 and subject to change without notice. Australian Medicines Handbook Pty Ltd as Trustee for The Australian Medicines Handbook Unit Trust. Level One, 231 North Terrace, Adelaide SA 5000. ABN 73 586 204 918.

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