Name and Mailing
Address of Recipient(s) For
an electronic newsletter subscription, you may add two co-workers
below at a very low additional cost. (* =required
field)
Name *
Title/Department
Company *
Address *
City *
State*
||||||||||| Zip/Postal
Code*
Country
Phone*
||||||||||| Fax:
E-mail address*
How did you
find us? *
Received Feb. 2004 mailing in 9x12 envelope
Other recent promotional literature in the mail
This web search engine:
Recommended by a colleague or friend
Other:
Why
we require an answer to the above question: we don't spam,
telemarket, or send junk faxes. We use other, less intrusive methods
which are more expensive; we need to know which advertising methods work
in order to keep costs and prices as low as possible.
Deliver
issues in this format
About the electronic format*
Paper, via fastest mail
HTML file attached to e-mail
You
may change formats at any time. Call 877-690-1871
Electronic
Subscription--$429/Year
Or add 1 co-worker-- just
$398/year for two of you Or add two co-workers at the
three-person electronic rate of $447/year
If you are ordering a paper newsletter
subscription or the CPOE Study only, skip these fields. For a group
subscription of more than three person, call us at 877-690-1871.
Second
electronic subscriber at your company
Name
Title/Department
Company
Address
City
State
|||||||||||
Zip/Postal:
Phone
Email
Third
electronic subscriber at your company:
Name
Title
Company
Address
City
State
||||||||||| Zip
Code:
Phone
Email
Your
Order And Payment Instructions:
Your
credit card:
VISA-
Mastercard-
AmEx
-
Discover
Enter your
card number and expiration date:
Cardholder:
Billing
address--tell us where to send bills and renewal notices: (Leave
blank if this is the same person as the first subscriber)
Billing name:
Billing title/dept:
Bill-to company:
Billing address:
Billing city:
Billing state:
|||||||||||
Billing Zip/Postal:
Billing country:
Billing phone:
||||||||||| Fax:
Billing e-mail:
To
Receive Your Newsletter by E-mail, You Must Affirm This User
Agreement:
The electronic version of Inside
Healthcare Computing is being licensed to the person(s) identified
above by Algonquin Professional Publishing, LLC., P.O. Box 818, North East, MD 21901 tel: 877-690-1871 .
You
agree to meet these terms: 1. That
you will pay for your subscription according to the terms above.
2. That authorized users
will not give any other person access to the
content of the newsletter, or to usernames and passwords,
by any means, including forwarded e-mail,
scanning, faxing, posting on electronic bulletin boards or networks,
or paper reprints. 3.
That the publisher of Inside Healthcare Computing has the right to
monitor use of this electronic subscription through the use of
delivery confirmation technologies and file downloads from the
Inside Healthcare Computing web site. 4. That these are the
remedies for failure to deliver: (a) a free copy for each copy not
delivered by 5:00 p.m. Pacific Time on the issue date; or (b) a
refund of the undelivered portion of the subscription; or (c) paper
delivery at prevailing prices for paper delivery. 5. That we
may terminate this subscription or the format of your choice at any
time without cause, upon which you will be entitled to your choice
of either (a) a refund of the remaining paid portion; or (b)
delivery on paper of the remaining paid portion at prevailing prices
for paper delivery. 6. That you will not modify or alter
the newsletter or the e-mail to which it is attached in any manner
or allow or cause either to be altered in any way or distributed in
any altered manner. 7. That you are authorized to make this
agreement on behalf of yourself and the other users named in this
form, and that you will provide copies of this agreement to them.
8.Venue: that this agreement is made in and enforceable
under the laws of the State of California.
Algonquin
Professional Publishing, LLC. agrees to meet these terms:
1. To send biweekly copies of the newsletter Inside
Healthcare Computing in your chosen format.
2. To provide usernames and passwords for
use only by those named in this form (or other recipients after you
notify us) to the Inside Healthcare Computing Electronic
Library at www.insidehealth.com .
3. That you may cancel at any time without
cause, upon which we will provide your choice of either (a) a refund
of the remaining paid portion; or (b) delivery on paper of the
remaining paid portion at prevailing prices for paper delivery.
By
clicking "send the order" below, you agree to the terms
above. A copy of these terms will be displayed in
the "Thanks" screen which follows.