Coders' Dictionary Order Form

____ My payment by check is enclosed. Make checks payable to TAO and mail to:

TAO CPT Books, P. O. Box 681806, Franklin, TN 37068-1806

Fax Charge Card Orders to: 615-791-6032

Charge to my Master Card VISA

Amount Authorized $ ________________

Card Number _______________________________________Expiration Date ____________

Name of Card Holder _________________________________________________________
(please print clearly and legibly)

Card Holder's Address ____________________________ Suite/Box/Apt _______________

City ___________________________ State _______ Zip _______________ + __________

Card Holder's Signature ______________________________________________________

Telephone in case of Questions: (______) ________-__________

Credit cards processed for the TAO by
Medical Association Management Services (MAMS) 615-794-1851

Contact Information:

TAO P. O. Box 681806, Franklin, TN 37068-1806

Tel: 615-794-1851 Fax: 615-791-6032 E-mail: [email protected]