Software Options Price Maintenance & Email Support Phone Support
(Maintenance & Email Support is Required)
CORTRAK® Network Version 5 Users ** $9500.00 $2500.00/yr *** $1200.00
CORTRAK® Network Version 10 Users**
$19,000.00 $5000.00/yr *** $2400.00
Additional 5 Users
$9,500.00 $2500.00 $1200.00
Total:

** The Network Version means that the data files will be located on a network server and you may have more than one computer at a time using the software.
*** A maintenance contract is required.


Required fields are in bold.

 Facility Information (Location where CORTRAK will be installed)
Company:
Address 1:
Address 2:
City:
State:
Zip/Postal Code:
Phone:
Fax:
 

 

 Billing Information
First Name:
Last Name:
Company:
Address 1:
Address 2:
City:
State:
Zip/Postal Code:
Phone:
Fax:
Email Address:     
 Shipping Information
Same as Billing?  
First Name:
Last Name:
Company:
Address 1:
Address 2:
City:
State/Province:
Zip/Postal Code:
Please Enter the Numbers at right
 
 
 Payment Information
Payment Type:
Purchase Order #: