Purchase order form

Please use this page to generate an order form to include with your payment.

  1. Complete the contact information and select the product(s) you wish to purchase.
  2. Click the "Create order form" button to generate an order form.
  3. Print the order form.
  4. Mail the order form, along with your payment to the address printed on the order.

Please note: this information is NOT automatically sent to RxKinetics.

For faster order processing, you may purchase via credit card:


Enter shipping information
Your name:  
Your Email address:  
  Area Code:  
Your telephone:
  Phone number:  
 
Institution name:
  Ordered by and pharmacy contact are the same
Pharmacy contact person:
Pharmacy contact Email:
Address line 1:
Address line 2:
City:
State:
Zip code:


Select product(s) to order
      Qty Price
  APK© for Windows Desktop Single seat $150 per PC
  APK© for Windows Desktop Site (network) $390 per business address
  Kinetics© for Windows Desktop Single seat $250 per PC
  Kinetics© for Windows Desktop Site (network) $650 per business address
  RxInterventions© for Windows Desktop Site (network) $590 per business address
  TPNassist© for Windows Desktop Single seat $250 per PC
  TPNassist© for Windows Desktop Site (network) $650 per business address
  UDlabels© for Windows Desktop Single seat $75 per PC
  UDlabels© for Windows Desktop Site (network) $195 per business address

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