For questions or to
sign up for Medical Director Services,
call F.D. Doc (Charles Truthan, DO,
FACOFP) at (352) 266-0460
Respiratory
Protection Program (RPP)
For Firefighters
Order Form
Instructions:
1. Print out this order
form & complete the information
2. MAIL
TO: F.D. Doc®
8927
SE 70th Terrace
Ocala,
FL 34472
| Quantity | Item | Extended Total |
| Respiratory Protection Program Manual (Includes Shipping & Handling) @ $ 275.00 | $ | |
| (Includes one year of updates) SUBTOTAL | $ | |
| Deduct $25 if you are an All Volunteer FD | - ($ ) | |
| Overnight Service add $ 30.00 per order | ||
| C.O.D. with 3 day service - Add $ 40.00 | ||
| Florida (taxable) Fire Departments Add 7% sales tax |
||
| ORDER TOTAL | $ | |
| Payable by Check, Money Order, or P.O. | ||
| (Optional) Purchase Order Number |
| Shipping Information | |
| PRINT the EXACT NAME to be printed on your manual below | |
| Manual Name: | |
| SHIP TO: | Fire Department |
| ATTN: | |
| Address: | |
| City: | |
| State: | |
| Zip Code: | |
| Phone: | |
| Fax: |
| Billing Information | |
| TO: | |
| ATTN: | |
| Email Address: | |
| Address: | |
| City: | |
| State: | |
| Zip Code: | |
| Phone: | |
| Fax: |
Make check or money
order payble to "F.D. Doc®"
Please Allow 3 to 4
weeks for UPS Ground delivery.
F.D. Doc® is the trademark of F.D. Doc Services, Inc. and F.D. Doc, P.C.