Literature Packet Order Form

LITERATURE PACKETS Quantity Ordered
Obsessive Compulsive Disorder - General Packet  
Obsessive Compulsive Disorder in Children & Adolescents  
OCD in the Elderly  
Trichotillomania in Adults  
Trichotillomania in Children  
Body Dysmorphic Disorder  
Obsessive Compulsive Personality Disorder  
Obsessions Without Compulsions  
Streptococcal Infections & OCD  
Schizophrenia & OCD  
Causes & Genetics of OCD  
Hoarding  
Scrupulosity  
Compulsive Skin Picking  
Compulsive Shopping  
Neurosurgery & OCD  
Pregnancy & OCD  
Tourette's Syndrome & OCD  
Total # of Packets Ordered  
Total Cost of Packets at $10.00 per packet $  
Shipping Charge $ 4.95
Optional Tax Deductible Donation to:
Madison Institute of Medicine $
 
TOTAL ORDER $  

Thanks for your interest in the Information Centers. In addition to our patient information booklets we offer packets with information addressing frequently asked questions. The cost for each packet is $10.00 plus shipping. To order packets please print out the order form and fill it out, then mail, fax, or call us with your order.

Ship To:
Name
Address
Address
City State
Country ZIP
Telephone
Method of Payment:
Check or money order made payable to:
Madison Institute of Medicine
MasterCard Visa
Acct # Exp. Date
Signature Date

 
Mail or Fax order to:
Madison Institute of Medicine
7617 Mineral Point Rd
Suite 300
Madison, WI 53717
Phone: (608) 827-2470
Fax: (608) 827-2479

© 2000, Madison Institute of Medicine