DMS Order Form

Advertisement Order Form:

DMS Internet Directories & Web Sites

How to use this Form:

u Use one Form per practice/organization. Type in the Form, on screen response, (fill out all applicable blanks).

u Press "TAB" to move between blank spaces. When finished, please print the Form. To view a directory's web site, please click on its title.

u Preferred payment: Check drawn on an American bank.

u PAYMENT - INTERNATIONAL ORDERS:
Preferred payment is by "Wire Transfer Of Funds". Also, when completing your bank's form, please request "Immediate" transfer of funds.
To receive DMS wire information, kindly contact our office by E. Mail:cidms@yahoo.com

u Acceptable payment: International Money Order or a check drawn on a local bank
by using your country's currency. Our bank will send the check back to country of origin for collection.
The process usually takes about 3-4 weeks.

n Contact DMS About Front Page Listing
And Multiple Directory Listing/Advertisement

Arab / Int'l Directories & Web Sites

1	Arab Family Web site & Dir.	$125
2	Arab Cancer Publications	$45/ea
3	Arab Health Directory	$115
4	Arab Kidney Transplant Dir.	$95
5	Arab Neurosurgery Dir.	$135
6	Arab Orthopedic Surgery Dir.	$135
7	Arab Ob & Gyn Directory	$145
8	Arab Physicians And Scientists Directory	$95
9	Arab/Int'l Children Disability Catalog	$95
10	Exceptional Arab Family Children With Special Needs	$55
11	Int'l Patients Programs	$145
12	Medical Specialists Finder	$75
13	Recommended Specialists	$75
14	Recommended World Hotels And Resorts	$95
15	World Specialists Directory	$85
16	2nd Opinion Specialists Dir.	$85

Total Fees (Except Cancer Pubs): $1,550

American/National
Directories & Web Sites

1	Adv. Phys Med. Rehab Dir.	$175
2	American Expatriates Directory	$95
3	Clinical Trials Registry	$65
4	Leisure World Today	$55
5	Medical Laboratory Directory	$45
6	Obstetrics & Gynecology Southern California Directory	$95
7	Provider Advocate	$35
8	O. C. Care Providers Dir.	$195
9	O.C. Businesses Directory	$175
10	O.C. Mental Disorders	$45
11	Women Doctors Directory	$125
12	Workers Compensation Dir.	$98

Total Fees: $1,203

Additional Services:
Development of multi-Language web pages
DMS develop web pages in 6 languages:
Arabic, English, French, German, Italian and Japanese More Info

Back To Home Page

.Please Complete and mark (X) applicable boxes:
.
e.Network Subscription Fees:
..............Individual: $79/year .Group: $385/year

e.Development of Arabic web page Up to 250 words (English language):
.... Fee : $189/web page
e.Number of Arabic web pages X $85/web page = $
Deadline (Payment received at DMS) .

e.Special Advertisement Fee $

...Brief Description of Service:
e
Deadline (Payment received at DMS) .

Additional Instructions: (Optional)

TOTAL FEES
Add amounts from selected boxes above and enter here $
Date.
Check Number.

.ORDER INFORMATION: (Please complete only applicable information)

.. Name .

Title

Special Interest

Department

Institution

Address

City

.State/Postal Code ..

Country

Country Code .City/Area Code.

Telephone number .FAX number

E - Mail Address

Web Site Address

USA Orders Only
Please Print Completed Form And Mail It With Your Payment To:
Doctors' Marketing Service
P.O. Box 748, Lake Forest, California 92609-0748

.
International Orders Only
After completing the Order form, DO NOT MAIL IT. To send the completed form, please Click on the button, below.
Also, your payment should be sent to DMS bank account by Electronic transfer of funds.
Please use the E. Mail Address: cidms@yahoo.com to request DMS Account Number.
>>> Please Review The completed Form before you click on "Send It in". <<<
.

u		Use one Form per practice/organization. Type in the Form, on screen response, (fill out all applicable blanks).
u		Press "TAB" to move between blank spaces. When finished, please print the Form. To view a directory's web site, please click on its title.
u		Preferred payment: Check drawn on an American bank.
u		PAYMENT - INTERNATIONAL ORDERS: Preferred payment is by "Wire Transfer Of Funds". Also, when completing your bank's form, please request "Immediate" transfer of funds. To receive DMS wire information, kindly contact our office by E. Mail:cidms@yahoo.com
u		Acceptable payment: International Money Order or a check drawn on a local bank by using your country's currency. Our bank will send the check back to country of origin for collection. The process usually takes about 3-4 weeks.