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You can order your card by direct mail or e-mail.

E-mail requires pre-payment using PayPal  
   
MAIL ORDERS: Please click MAIL ORDERS link to get a mail order form.
Mail a copy with your check or money order to:
  MY JOINT ID CARD
 115 Club Court,
Alpharetta, GA. 30005-7424.   Or, Fax to 1-678-762-0158 
   
Internet Orders: Please Use E-mail order form below
 All Internet orders are for standard cards and must be PRE-PAID by using  PAYPAL. $17.00 primary card $8.00 each extra card. Please contact us for Custom cards.
You can use your TAB key to move through the form.

When completed use the SUBMIT button at the bottom of the page to place your order.
Once submitted you will see a copy of your  order. When you go back to the order form it will be cleared of your data, but the order was placed. You do not need to re-place it.

We will e-mail a confirmation of order and payment.     

IF YOU HAVE ANY PROBLEMS SENDING ORDER FORM PLEASE CUT, PAST and E-MAIL to: myjointidcard@bellsouth.net


 

                             E-Mail ORDER FORM FOR MY JOINT -ID CARD
 
 Please Enter Today's Order Date -- mm/dd/yy                             
 Order one Primary card @ $17. each       Order # of  Extra Cards @ $8.00 each ?    
Total # Cards Ordered?     Total Payment    Georgia residence add 7% state sales tax   
            For Credit Card orders, a  $1. processing fee is included in your Paypal card price.
Patient Information for Shipping Order & How You Want data on the Card

Name of Patient
Street Address
City   State Zip Code 

Please provide the following contact information in case we have a question on your order

  Phone#   
Email

Please provide the following Surgical information:  
 Enter the date of Surgery.. ( mm/dd/yy)
 Type Implant:  HIP [ Hip replacement ]  KNEE  [ Knee replacement ]  Other 
  (right or left side; bilateral etc.)
For other  Implant or, to add more specific information, please use "additional information" section below.                   

Name of Doctor
Name of  Practice or Hospital
Street Address
City   StateZip Code
Phone#   Email or web
Name of office contact                    

 

Any additional Information  or  Special requests       
  

                             to pay