ORDER FORM - Individual booklets
Quantity
Price per booklet *
(based on total booklets ordered)
Total
Finding Your Way
booklet
# English:
One booklet: $1.50
# Spanish:
2-5 booklets: $1.25 each
Mrs. Lee's Story
booklet
# Chinese/English:
Total # Booklets:
* Total price includes
shipping and tax.
Total $
Mailing Information
Name:
Mailing Address:
City:
State:
Zip:
Daytime phone:
Email (Opt.):
To order, complete and print this form.
Send with your check (made payable to SHD) to:
Sacramento Heathcare Decisions
3400 Data Drive
Rancho Cordova, CA 95670
Questions? Contact SHD at (916) 851-2828.
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