*
*The Discharge Planner Issue Order Form
*
Individuals: To obtain a copy of The Discharge Planner, Hard Bound or CD, just Call, Write, E-Mail or FAX your request to-- The Discharge Planner, Inc.. at the address below.
*
Issue Order Form - For Facilities & Services
*
*
Contact Person: _______________________Position:_________________________
*
Company:_____________________________Address:________________________
**
City:____________________________State:______ Zip:_____________________
*
Phone:_________________Fax:_____________ E-Mail:______________________
*
# Books: ______ # CD'S:______ Note:_____________________________________
*
*
E-Mail: BerniSwanson@msn.com
*
Office:*951.656.2943****Fax: 951.653.6445
*
The Discharge Planner, Inc.
6180 Quail Valley Ct., Suite 310, Riverside, CA 92507
*
**
*