Order Supplies

Quantity	Item	Rate
	Encounter Worksheets (2 pads of 100)	$15.00
	Patient Education & Monitoring "Mini" Forms (2 pads of 50)	$15.00
	Comprehensive Medication Review (CMR) Worksheets (2 pads of 25)	$10.00
	Therapy Assessment Guide (TAG) – PPI (2 pads of 25)	$10.00
	Therapy Assessment Guide (TAG) – Statins (2 pads of 25)	$10.00
	Therapy Assessment Guide (TAG) – PPI/Statin Combo (1 pad of 25 each)	$10.00

Quantity	Item	Rate
	Personal Pharmacist Program Starter Kit (each) – SAVE 25%	$60.00
	Personal Pharmacist Program Brochures (package of 20 plus 5 return envelopes)	$10.00
	Personal Pharmacist Program Display Stand (each)	$10.00
	Personal Pharmacist Counter Mat (each)	$10.00
	Personal Pharmacist Sample Patient Enrollment Folder (2 sets)	$10.00
	Personal Pharmacist Sales Instruction Guide (each)	FREE
	Medication Risk Index Assessments (2 pads of 50 plus 1 key)	$15.00
	Participating Pharmacy Window Clings (package of 5)	$10.00
	Medication Check Up Bags (package of 20)	$15.00

Quantity	Item	Rate
	Personal Pharmacist Training CD-ROM (each)	$10.00