How To Place An Order

You may order the Pd-103 or I-125 seeds three convenient ways:

1. Call 1-877-438-4125 to speak to a Brachytherapy Service Specialist.

2. Fax your order using the Pd-103 or I-125 Seed Order Form. PSA Customer Service will process your order and send you a confirmation via fax within 30 minutes. Please be sure to include your phone number so that we may contact you if we have any questions.

3. Request electronic template and send via e-mail to kathy@prostateservices.com. As with faxed orders, a confirmation will be sent within 30 minutes.

Information needed to order:

1. A valid copy of the Radioactive Material License must be on file with Prostate Services of America before an order can be shipped.

2. Re-Sale Certificate must be on file or taxes will be added to all orders.

3. Fill out the enclosed account information document.

4. Fax the above mentioned documents to Prostate Services of America at (561) 842-6660, Attention: Kathy Youney.

Type of orders:

1. Contract Order - Standing or regular order for the customers that enjoy value added programs with PSA.

2. Standing Order - Customer provides PSA with blanket purchase order for a designated amount of time. A pre-determined number of seeds is shipped automatically on a weekly basis.

3. Regular Order - Customer places order with PSA each time a shipment of seeds is requested.

Call today to place your order
or to speak to a sales representative to set up your account.

PSA Customer Service
Customer Service hours: Monday through Friday 9:00 a.m. - 5:30 p.m. CST
Phone: (877) 438-4125 Fax: (561) 842-6660
www.prostateservices.com

Please fax form to Prostate Services of America, Inc.
Customer Service at 1-561-842-6660.

 

Company Name:	_______________________________
Representative Name:	_______________________________
Phone Number:	_______________________________
Fax or Email:	_______________________________

 

Hospital Name:	________________________________
Attn:	________________________________
Address:	________________________________
City, State, Zipcode:	________________________________

Implant Date:_______________	Product Code:___________
Seed Amount:______________	Activity:__________
Check One:	mCi (AappT97):_____
	NIST (SkN99):_____
Seed of Known Activity:	Yes:_____     NO:_____
Patient Name:	_______________________
Radiation Oncologist:	_______________________
Customer Purchase Order Number:	_______________________