Acceptable forms of payment are Cash, Check, Money Order or Bank Check.
My Medical Planner Mail order
Print out the following order form and : Mail it to:
My Medical Planner
PO Box 21785
Sarasota, Fl 34276
Yes, rush me The "My Medical Planner". The My Medical Planner will be sent within 72 hours of receiving your check or money-order and will arrive in about 4 to 7 business days. We use USPS mail with Delivery Confirmation. NOTE: Checks must clear and the Medical Planner will be sent within 24 hrs after the check clears. No Foreign Checks.
Name: _________________________
Email: _________________________ for confirmation if you have one
Company (optional): _________________________
Address: _________________________
(please be sure to enter a physical mailing address, if you
enter a P.O. box, your Planner will be sent by regular post
and can take up to 2 weeks to arrive)
City: _________________________
State: _________
Country: _________________________
Zip: _________
Phone: (___) ____ - ______
( ) I am enclosing $24.95 a check (USA funds only) or money order for The My Medical Planner
( )I am enclosing $17.95 a check (USA funds only) or money order for The MY Medical Planner Binder only. ( )$4.95 shipping and handling Media Mail USPS (includes delivery confirmation). (usa only)
( )insurance $1.30 per $50.00 order
Please note that we do not accept checks by fax, so if you are paying by check you must mail it in or use PayPal.
( ) I am enclosing $_________ for The My Medical Plannernote: For assistance email me Support for this form.
- _____________________