Women's Heart Foundation AED Accessories Order Form
Replacement Batteries, Pads, Event Reader, Carrying Case and Wall Signs
Please print this order form, fill it out and mail it to:
Women's Heart Foundation, PO Box 7827, Trenton, NJ 08628
or Fax to (609) 771-3778.
Please make checks payable to WHF Thank you!
| ITEM | Cost |
Quantity |
Total |
| Batteries | |||
| 5-year Battery Pack with 9V Lithium Battery/ DCF-200 | $149 | ||
| 7-year Battery Pack with 9V Lithium Battery/ DCF-210 | $199 | ||
| 9V Lithium Battery/ DAC-410 | $9 | ||
| Defibrillation Pads and Adapters | |||
| Adult Defibrillation Pads/ DDP-100 | $38 | ||
| Pediatric Defibrillation Pads/ DDP-200P | $99 | ||
| DDP-100 to Medtronic QC Adapter/ DAC-300E | $99 | ||
| DDP-100 to Zoll M-series Adapter/ DAC-310E | $99 | ||
| Lifeline Documentation | |||
| Quick Use Care/ DAC-500E | $9 | ||
| User Manual/ DAC-510E | $19 | ||
| Sales and Marketing Materials | |||
| Lifeline Specification Sheet/ DAC-700 | $0.25 | ||
| Defibtech Sales Brochure/ DAC-725 | $0.50 | ||
| Defibtech MD Brochure/ DAC-726-DFT | $0.50 | ||
| 2-Pocket Marketing Folder/ DAC-740 | $1.00 | ||
| Training Packages | |||
| Standalone Trainer Package/ DCF-350T | $399 | ||
| Training Package (DBP-RC2,DTR-201,DTR 301)/ DCF-302T | $249 | ||
| Training Package (DCF-302T, DTR-400 remote)/ DCF303T | $289 | ||
| Training Accessories | |||
| Rechargeable Training Battery Pack/ DBP-RC2 | $149 | ||
| Training Battery Charger (US)/ DTR-201 | $49 | ||
| Training Remote Control and Batteries/ DTR-400 | $49 | ||
| Training Software Card/ DTR-301 | $75 | ||
| Training Pads | |||
| Adult Training Pads (1 set pads and connector)/ DDP-101TR | $29 | ||
| Adult Training Pads (5 pack-pads only)/ DDP-105TR | $29 | ||
| Pediatric Training Pads (1 set pads and connector)/ DDP-201TR | $29 | ||
| Pediatric Training Pads (5pack-pads only)/ DDP-205TR | $29 | ||
| Data Cards and Reader | |||
| Medium Capacity Data Card/ DDC-8 | $79 | ||
| Medium Capacity Data Card, w/Audio/ DDC-50AE | $79 | ||
| Large Capacity Data Card/ DDC-12 | $99 | ||
| Large Capacity Data Card, w/Audio/ DDC-100AE | $99 | ||
| Data Card Reader/ DDC-CR1 | $75 | ||
| Carry Cases and Wall Cabinets | |||
| AED Soft Carrying Case/ DAC-100 | $99 | ||
| Red Trainer Soft Carrying Case/ DAC-101 | $99 | ||
| Standard Hard Carrying Case - Black/ DAC-110 | $149 | ||
| Deluxe Hard Carrying Case - Yellow/ DAC-111 | $199 | ||
| Wall Mount Bracket/ DAC-200 | $59 | ||
| Wall Mount Cabinet/ DAC-210 | $299 | ||
| Wall Mount Cabinet with Alarm/ DAC-220 | $349 | ||
| AED Signage | |||
| 3-way AED Wall Sign/ DAC-230 | $14.95 | ||
| 2-way AED Wall Sign/ DAC-231 | $14.95 | ||
| AED Inspection Tag/ DAC-801 | $1.00 | ||
| Vehicle Sticker/ DAC-802 | $2.00 | ||
| Facility Sticker/ DAC-803 | $2.00 | ||
| Rescue Accessories | |||
| Resuce Pack/ DAC-420 | $25 | ||
|
Subtotal
$ |
| ||
|
Shipping and Handling |
$25.00 | ||
|
TOTAL DUE |
$ |
Your Name _______________________________________________________
Company Name ___________________________________________________
Mailing Address ___________________________________________________
City ________________________ State _______ Zip Code _________
E-mail address: _____________________________________________
Charge it to my: Master Card _____ Visa _____
Name on card: ___________________________________________________
Card number: ___________________________________________________
Expiration date: _________________________________________________
Thank you for your order.
All proceeds support heart disease prevention programs to reduce risk and save lives.
- The Women's Heart Foundation