Care Providers' Referrals Exchange
How to use this Form:
||Use one Order Form
||Type in the Form, on
screen response, (complete applicable blanks).
||Press "TAB" to move between
||DO NOT press the "BACK"
button because all information will be deleted if you leave this web page.
like to order the design of a Care Providers' Referrals Exchange
printable web site from the following website:
dditional printable websites:
Please send a list of their Internet addresses by E. Mail to:
Develop the care providers' referrals websites from
the Internet addresses of above web pages
provided by the client. Their features are the following:
- The website address (bottom of the page) will have the client's
name and the care provider's name.
- Left column is reserved for the care
provider who approve its contents typically taken from his/her website.
- Right column is reserved for the client who
approve its contents typically taken from his/her website.
- The client may order multiple printable
websites to develop a "NETWORK" of
- Checks only, no
- Orders are
paid in full and in advance
- Check Number
- Payment Date
Name And Contact Information:
Sending The Order
copyright© 2018 Doctors
Please complete, then print the Order Form and mail it with your
Doctors' Marketing Service
P.O. Box 748
, Lake Forest, California 92609-0748