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hspinc.com
HSP / ADAA
Order Form for Doctors, Assistants and Hygienists

I recommend the following three topics be considered for future videotapes:__________
________________________________________________________________________
*Each videotape comes with one (1) ADAA 2-Hr. CE Credit Test for any auxiliary or   doctor.
                                 ADAA Fellowship / Mastership Credit
                                          AGD Approved National Sponsor

QTY I wish to order:
_____$99.00 Clinical Dynamics of Four-Handed Dentistry
_____$89.00 ADAA Member Price
_____$99.00 Infection Control in the Dental Office
_____$89.00 ADAA Member Price
_____$99.00 Medical Emergencies in the Dental Office
_____$89.00 ADAA Member Price
_____$____________ Subtotal Amount: For Videotapes
_____$44.00 Each Additional Four-Handed Dentistry ADAA Test*
_____$44.00 Each Additional Infection Control ADAA Test*
_____$44.00 Each Additional Medical Emergencies ADAA Test*
_____$____________ Subtotal Amount: For Additional ADAA Tests
_____$____________ Total Amount: Videos & Tests (Before Tax)
            $____________(Alabama residents add 8% tax on videos and tests)
_____$____________ $2.00 Per Ea. ADAA Test Shipping & Handling
_____$____________ $5.00 Per Ea. Video Shipping & Handling
            $____________ Total Purchase (Be sure to include the S&H)

Enclose check or credit card number and mail or fax to:
And Make Checks Payable to:

H S P, Inc.
1000 11th Court West
Birmingham, AL 35204-1808
1-800-237-5794 Website:www.hspinc.com
Fax: 205-251-0419 e-mail: hspinc@wwisp.com