Select to return to your home page

PO Box 244    THE JUNCTION

NSW 2291 AUSTRALIA
FertAid Pty Ltd            [ABN 62-093-199-529] Connecting Professionals with Current and New Technologies  Phone: 61-(0)2-4963-1226
  Fax     :61-(0)2-4963-1228
TAX INVOICE - PLEASE PRINT AND POST or FAX 61-(0)2-49-63-1228 TO SUBSCRIBE WITH PAYMENT. www:fertaid.com - office@fertaid.com

Clinic (group) Subscription to QAPon-line at FertAid.com for 2012

**SPECIAL OFFER FOR ESHRE MEETING 2009- 50% discount for 2009 PLUS 2008 FREE ACCESS**

Scheme Number/Discpline
Andrology-QA
Andrology-Testing
Embryology
Endocrinology+AMH
Ultrasound
Please Note: The list displayed is only for scheme that require a paid subscription. Other schemes that are free are not displayed.
Sperm Morphology - WHO 4th Edition. Sperm Motility.
Sperm Morphology-WHO 5th Edition 2010 Sperm Concentration-haemocytometer
Sperm Concentration-Makler ASAB by Immunobeads Assay
Concentration/Motility EQA-CASA SCA - MicrOptics Sperm Morphology EQA- CASA SCA system - Microptic
Halosperm EQA Sperm Chromatin Structure.
Embryo Fragmentation. Pronuclear Embryo Assessment
Human Cleavage Embryology Late Human embryology
Claevage/Blastocyst Ranking and Selection Human Ova
anti-Müllerian hormone [AMH] Endocrinology-Follicular Phase Serum Oestradiol
Endocrinology-Follicular Phase Serum FSH Endocrinology-Follicular Phase Serum LH
Endocrinology-Follicular Phase Progesterone IVF Endometrial Estimation
IVF ultrasound
Type of Subscription
*,QAP-online will create a record of your subscription as the QAP supervisor and your Clinic as a QAP group. Your staff will be able to register online, link their registration to your QAP group and then enroll online without further payment. 
Individual One Staff/One scheme Discipline * All staff/One Discipline
Scheme* All staff/one scheme Global * Al Staff/All schemes
Payment

Please complete payment details for all staff in the one clinic. Please write clearly

Fee*
$USD
$AUD
Euro
2012 Lab Fee
100
110
50
Single-2012
25
28
20
Scheme-2012
250
275
150
Sperm DNA EQA 2012
375
375
250
Halosperm Sperm EQA
200
220
150
Discipline-2012
500
550
250
Global-2012
1,000
1,100
500
Endocrinology 2012
275
275
200
CASA EQA 2012 for MicrOptics SCA
150
165
100

*inc GST

Individual One Staff- one scheme
Scheme All staff- one scheme
Discipline All staff - one discipline
Global All staff- all schemes

 
AMOUNT DUE: $USD $AUD Euro
Cheque Credit Card Bank Transfer Order Number
Credit Card Details VISA  MasterCard Bankcard 
Name on Card:    CV Code: Expiry Date:
       
---
        
---
        
---
        
Direct Bank Transfer Payable to Commonwealth Bank of Australia   Acc Name: FertAid   Acc No: 062-821-1009-4608
Transferring Bank
      Date Transfer Requested:
 Order Number:   Name of Authorising Authority:   Signature:

Contact Details

Details of Clinic and Contact Details of Authorised Staff Member

[your logon code and  password will be sent to this e-mail if completed- please print clearly]

Office Use Only:Clinic:_________

Logon:_________Password:___________
Your Full Name:
  - Signature Date :
Institution/Clinic
 
Address:
 
:Telephone:
  Fax:
  e-mail address::