Phys-X Order Form

Your Name _________________
Facility Name _
Address __
City State Zip _
Phone
Fax ____

Basic (3.9) English Only .......... $195.00
Basic (3.9) Spanish/English ......... $295.00
Ver 3.9 Extra License ......... $50.00
Advanced (6.0) English ..........$295.00
Advanced (6.0) Span/Eng ..........$395.00
Ver 6.0 Extra License ......... $60.00
Sub Total _
CA residents add 7.75% sales tax _
Shipping ...... $5.00
Total ___

..... Print and Fax this form with your Company Purchase Order to 707-882-3950 .....

Shipping is via Priority Mail (2nd day)

To Order... Call toll free: (800) 265-1950
Fax: (707) 882-3950

Mail Address
Arena Health Systems
PO Box 341
Point Arena, CA 95468

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