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Supply Order Form

Your Name:
Dr's Name:
Email Address:
Phone Number:

Statement Pack

Includes:
1000 Statements, 1000 Double Window Envelopes, and 1000 Single Window Envelopes.

Laser Statement Pack $115.00 (1)

Billing Statements

Includes:
1000 Billing Statements

Laser Statements $42.00 (1)

Envelopes

Includes:
2 boxes (500 count each) of envelopes. 1000 total. You may check both boxes to order 1000 of each type of envelope.

Single Window (1000 count) $40.00 (1)
Double Window (1000 count) $40.00 (1)

Please choose a shipping method:

Standard shipping usually arrives in 4 to 5 business days.

    

Please choose a payment option:

Remember that shipping charges will apply. CODs carry a $7.50 service charge.
Make sure that Data Team has your card number on file if you choose Master Card or Visa.

        

Please list any special instructions here:

Please click the Submit Button only once!




We're always glad to be of help!


 

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Data Team Corporation - Dental Office Management Solutions - 800.359.6840