MEDISOFT PURCHASE ORDER FORM
ONLINE SPECIALS

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1) Please enter the quantity, type for each item you are purchasing..
Check Special below or CALL Now 888-987-9335 to obtain the Current Special Price!
2) Please fill in the billing & shipping fields below.
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3. Click on the Submit Button once.
Please Send us email or call 888-987-9335 if you have any questions.
MEDISOFT PRODUCTS
Item# Qty Price (US $) Description, Product Type, Options
01 1. Just Claims
02 2. Basic Patient Accounting
   Item 23 Training Special is recommended w/item 02
03 3. Advanced Patient Accounting
  Item 23, Training Special is recommended w/item 03
04 +

Check Special
4. Medisoft Network PROFESSIONALWIN 2000, WIN XP
Item 23, Training Special is recommended w/item 04
05 5. Medisoft Advanced Reporting
08 8. Medisoft Encoder PRO
09 9. Medisoft E.R.A. Auto Pay, WIN (works with item 13)
  <== Additional Price Specials when ordering item 13
12 12. Codes on Disk, ALL Specialties
13


+
13. Medisoft Electronic Claims Direct See Details
   1. Please Select STATE (TYPE):
   2. Please Select STATE (TYPE):
14 14. Medisoft Final Draft Word Processor
15



15. MedicServe Custom Medisoft Forms
A) W.C. & NO FAULT Report & Printer Form
16 16. Medisoft UB-92 Custom Report
17




+
17. Medisoft Office Hours PRO Single User
OR
17. Medisoft Office Hours PRO Networked
Licenses are not required, if you have Medisoft Net Pro. (item 4) Licenses
19 19. Medisoft Software On Site Hands on Training
20 20. Medisoft Video Training Seminar V8 DVD
21 21. Medisoft Software Remote Hands On Training
23 23. Medisoft Interactive Video Training on CD ROM(8)
25 25. MedicServe 6-month phone, email, remote online support
26 26. MedicServe 12-month phone, email, remote online support
27 27. MedicServe 12-month Titanium Umbrella phone, email, Remote Online Support Plus Free Upgrades
28 28. MEDISOFT DEMO on CD
29 29. CURRENT SPECIAL HARDWARE COUPON
  Purchase Order for Billing Service Special Bundles
  Purchase Order for Medical Practice Special Bundles
As with most software/literature products, since they can be copied, ALL SALES ARE FINAL. However, if your product is damaged, we will replace it at no charge. We make every effort possible to help you choose the right products for your specific needs, and we provide initial set-up installation support. If you are not sure, we recommend that you send us a Inquiry for Medisoft Product Consultation.
Thank you for choosing Medisoft Products


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Expiration Date: Month Year


If you prefer to provide credit card information by phone, or pay by check, or money order, then please type your telephone number here, and complete the fields below. Although we have never had any issues, MedicServe is not responsible for any loss, as a result of submitting this online order.

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Customer Billing Information:
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Our E-mail address is:
Sales@medicserve.com
Our Toll Free Number is 888-987-9335
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