SleepGen Order Form

The Patient Data Entry Form and Report Generator, from Sleep Multimedia Inc.

Print out this form, complete, and send with payment to Sleep Multimedia Inc.

Name :
Title :
Institution:
Address1 :
Address2 :
City : State: Zip:
Country :
Telephone: Fax:

Cost: Personal Use: $495, Shipping (USA) $15, Shipping (Other) $35.

Check Visa MasterCard Amex

Name :
Card Number: Expiry Date:
Cost : Shipping: Total:
Signature :

    Minimum System requirements:
    • IBM PC or compatible computer
    • 16 MB RAM
    • Pentium or higher processor
    • Microsoft Windows 3.1 or higher
    • SVGA monitor 800x600x256 color
    • Windows compatible mouse

Windows 3.1, Win 95, Win98 and Win NT compatible. Note: The greater the computer power and the higher the color spectrum of your display card, the better the quality of the images.

Table of Contents:

SleepGen Illustrations

SleepGen Home Page

Sleep Medicine Home Page

Send or fax completed form to: Sleep Multimedia Inc., P.O. Box 329-H, Scarsdale, N.Y. 10583. Phone: 914-722-9291 Fax: 914-722-4490

Copyright (c) Sleep Multimedia Inc.,1994, All Rights Reserved. SleepGen is a trademark of Sleep Multimedia, Inc.