Get Psychosexual History Questionnaire Pdf

00 175. 00 M SI Documentation M anual 90. 00 Psychosexual Life History Adult Male English - 5 copies 20. 565. 0164 www. NicholsandMolinder. com e-mail address sales nicholsandmolinder. com Original MSI 1984 and Psychosexual Life History Responsible Clinician s Information Name and Degree Agency Name Ship to Address PAYMENT METHOD 9 VISA or 9 MASTERCARD V Code last 3 digits on signature line Phone Fax e-Mail Address Signature Date Quantity XXX Description Price M SI Kit includes A 2B C D E Adult Male MSI Adolescent Male MSI J 350. NICHOLS MOLINDER ASSESSMENTS INC. 437 Bowes Drive Fircrest WA 98466-7047 USA Telephone 253. 565. 4539 Fax 253. 00 Adult Adolescent Male 1 manual A M SI Test Boo klets 10. 00 M SI Cassette Recording of Questions 65. 00 Adult Female English - 5 copies Adult Male Spanish - 5 copies WA SALES TAX We only accept Purchase Orders from U. S* State/ County/Federal or Canadian Provincial/Federal Agencies. 1 Release of liability for use of copyright materials. 2 Requirement for insurance coverage. 3 Indemnification against liability. 4 Re quirem ent of a fee to do busin ess in their locale. 9-11-09 25. 00 use your local tax rate Shipping Handling see chart Priority USPS TOTAL SHIPPING HANDLING CHART subject to actual shipping cost Location Rate Minimum United States Pacific Mountain Time Zones Canada Mexico M SI Scoring Templates E 9 Check 9 Purchase Order D Name of Cardholder We do not accept Purchase Orders which contain M SI Answer Sheet / Profile Forms C Zip Code of Cardholder 600. 00 Adult Male - 25 copies B Total Expiration Date Outside North America Eastern Central Time Zones ALL PACKAGES THAT ARE SHIPPED OUTSIDE THE UNITED STATES ARE SENT BY GLOBAL EXPRESS* Washington State Sales Tax In-State Sales Only AS A CONDITION OF THIS SALE PURCHASER AGREES NOT TO REPRODUCE OR ADAPT THE MULTIPHASIC SEX INVENTORY MATERIALS IN ANY MANNER OR BY ANY MEANS. 00 Adult Female English - 5 copies Adult Male Spanish - 5 copies WA SALES TAX We only accept Purchase Orders from U. S* State/ County/Federal or Canadian Provincial/Federal Agencies. 1 Release of liability for use of copyright materials. S* State/ County/Federal or Canadian Provincial/Federal Agencies. 1 Release of liability for use of copyright materials. 2 Requirement for insurance coverage. 3 Indemnification against liability. 4 Re quirem ent of a fee to do busin ess in their locale. 2 Requirement for insurance coverage. 3 Indemnification against liability. 4 Re quirem ent of a fee to do busin ess in their locale. 9-11-09 25. 00 use your local tax rate Shipping Handling see chart Priority USPS TOTAL SHIPPING HANDLING CHART subject to actual shipping cost Location Rate Minimum United States Pacific Mountain Time Zones Canada Mexico M SI Scoring Templates E 9 Check 9 Purchase Order D Name of Cardholder We do not accept Purchase Orders which contain M SI Answer Sheet / Profile Forms C Zip Code of Cardholder 600. 9-11-09 25. 00 use your local tax rate Shipping Handling see chart Priority USPS TOTAL SHIPPING HANDLING CHART subject to actual shipping cost Location Rate Minimum United States Pacific Mountain Time Zones Canada Mexico M SI Scoring Templates E 9 Check 9 Purchase Order D Name of Cardholder We do not accept Purchase Orders which contain M SI Answer Sheet / Profile Forms C Zip Code of Cardholder 600. 00 Adult Male - 25 copies B Total Expiration Date Outside North America Eastern Central Time Zones ALL PACKAGES THAT ARE SHIPPED OUTSIDE THE UNITED STATES ARE SENT BY GLOBAL EXPRESS* Washington State Sales Tax In-State Sales Only AS A CONDITION OF THIS SALE PURCHASER AGREES NOT TO REPRODUCE OR ADAPT THE MULTIPHASIC SEX INVENTORY MATERIALS IN ANY MANNER OR BY ANY MEANS.