 


 
For questions or to
sign up for Medical Director Services, call F.D. Doc (Charles Truthan, DO,
FACOFP) at (352) 266-0460 |
|
Respiratory
Protection Program (RPP) For Firefighters
Order Form
Instructions: 1. Print out this order
form & complete the information 2. MAIL
TO: F.D. Doc® / Truthan Enterprises
8927
SE 70th Terrace
Ocala,
FL 34472
Quantity |
Item |
Extended Total |
|
Respiratory Protection Program Manual (Includes Shipping &
Handling) @ $ 275.00 |
$ |
|
(Includes one year of updates)
SUBTOTAL |
$ |
|
Deduct
$25 if you are an All Volunteer FD |
-
($ ) |
|
Overnight Service add $ 30.00 per order |
|
|
C.O.D. with 3 day service - Add $ 40.00 |
|
|
Florida (taxable) Fire Departments Add 7% sales
tax |
|
|
ORDER TOTAL |
$ |
|
Payable by Check, Money Order, or
P.O. |
|
|
(Optional) Purchase Order Number |
|
|
Shipping Information |
|
PRINT the EXACT NAME to be printed on your manual
below |
Manual Name: |
|
SHIP
TO: |
Fire
Department |
ATTN: |
|
Address: |
|
City: |
|
State: |
|
Zip
Code: |
|
Phone: |
|
Fax: |
|
|
Billing Information |
TO: |
|
ATTN: |
|
Email
Address: |
|
Address: |
|
City: |
|
State: |
|
Zip
Code: |
|
Phone: |
|
Fax: |
|
Make check or money
order payble to "Truthan Enterprises" Please Allow 3 to 4
weeks for UPS Ground delivery.
F.D. Doc® is the
trademark of F.D. Doc Services, Inc. and F.D. Doc, P.C. |