PROFESSIONAL
ORDER FORM

To order Heartmates materials, simply SUBMIT this form. You will receive a copy of this order form in your electronic mail. Just print the email and mail it with your check or money order to the address provided. We will invoice you if you provide a VALID PURCHASE ORDER NUMBER from your health care institution.

MinervaPress
Dept. W-5
PO Box 16202
Mpls. MN 55416

Qty:  

print copies of Heartmates A Guide For the Spouse and Family of the Heart Patient at

Qty:  

cases of Heartmates A Guide For the Spouse and Family of the Heart Patient
 single case - 26 books @ $346.00 if given away or @ $364.00 if resold;
double case - 52 books @ $481.00 if given away or @ $494.00 if resold.

a single case at if  given away or if for  resale

a double case at ---if given away or --- if for resale.

Qty:  

print copies of The Heartmates Journal at $14.95

Qty:  

cases of The Heartmates Journal at $240.00 (30 books)

Qty:  

Mini-Pak (5 Heartmates and 5 Heartmates Journals) at

Qty:  

Portrait of the Heartmate Videoseries at special discount

Qty:  

The Cardiac Family Recovery Program Training Manual at

Qty:  

packages of 100 Heartmates 10 Healthy Hints Laminated cards- or FREE with $200 purchase

Name

PO Number

Institution

Dept.

Billing Address

City

State/Province

Zip/Postal Code

Phone Number

Email Address

SHIPPING ADDRESS
(  Check here if address is same as above)

Dept.

Shipping Address

City

State/Province

Zip/Postal Code