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                              PT DocTools Order Form

Thank you for your interest in PT DocTools.  Please print this form and complete it by hand.  Mail the
form and a check or money order payable to Knees Software, LLC, 20000 Hermitage Lane SE, Monroe, WA  98272.

First Name          Last Name
Title                
Clinic Name   
Address            
City                       State      Zip Code  
Telephone              Fax  
Email              

Each Windows computer that the PT DocTools Documentation System will be running on requires a
license.  A license for a single PC is $299.00  OR  $549.00 for all the PCs at a single clinic.  Credit for the
price of a single PC license will be applied to a future purchase of a clinic license.  A multi-clinic license for
the documentation system is $949.00.  The Appointment Scheduler is $99.00 for a PC or clinic license; $149 for
a multi-clinic license.

Order Total
  A single PC Clinic License Multi-clinic License Total
Documentation System $299.00 $549.00 $949.00  $
Appointment Scheduler $99.00   $99.00 $149.00  $

Sub-Total   

 $
8.5% Sales Tax (Washington Residents only)    $
Total Amount    $

Include a check or money order payable to Knees Software, LLC for the Total Amount above.
Orders will be shipped via US Postal Service within 2 business days.  A confirmation email will be sent to you.

Purchaser

Seller
Name:___________________________________ __________________________________________
Signature:________________________________ __________________________________________
Date:     _________________________________ __________________________________________

A copy of this order form, signed by a representative of Knees Software, LLC, will be returned with your order.

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