Ostomy Association of Melbourne Inc
Reg No: A0025655X
ABN: 93 953 917 074
Burwood Industrial Park, Unit 14, 25-37 Huntingdale Rd Burwood VIC 3125
Ph 03 9888 8523 Fax 03 9888 8094 Email [email protected]
ORDER FORM
SEE REVERSE FOR ORDERING GUIDELINES
Member Number:
Date:
Surname:
Initials:
Address
Postcode:
Phone:
Email:
For the Month of:
Post or Pickup
Brand Name Product Code
(please circle)
Description
Quantity
FREIGHT
Victoria $10/Interstate $12
$
ANNUAL FEES
Full member $55/Pensioner $40 (due in June)
$
DONATION
Donations over $2.00 are tax deductible
$
TOTAL PAYMENT $
Payment Method :
Cheque/Money Order ☐
Visa/Mastercard ☐
Minimum credit card payment is $20 which will cover two Victorian deliveries
Multiple deliveries may be paid in advance. Funds will be held in member’s personal postage account
Card No:
____/____/____/____
Cardholder’s signature
Expiry:
__/__
_______________________________________
Please allow ten business days for deliveries and three business days for pickups
ONCE YOUR ORDER FORM HAS BEEN SUBMITTED WE ARE UNABLE TO MAKE ALTERATIONS
Ordering Guidelines
Orders must be in writing by post, fax or email - phone orders will not be accepted
Complete the form fully, including the codes for the products required. Our processors work from the
codes – ensure they are listed correctly
Include a daytime phone number
Orders not clearly marked for pick-up will be posted at the member’s expense
Please allow ten business days for deliveries and three business days for pickups
Check contents immediately after arrival – ensure products and quantities are as expected and
promptly notify OAM of errors
Monthly Limits
The government limits ostomy products per calendar month – discuss the limits with a stomal
therapist and order within the guidelines
Orders cannot be backdated – once a month is over it is deemed that month’s products were not
required
Final orders for each month will be accepted until noon on the last business day of the month
Orders may be submitted up to 5 days prior to the first day of the month – orders submitted earlier
will be discarded
Payments
Credit cards: Minimum payment is $20 - this will cover two Victorian deliveries. Larger payments are
welcome – funds will be held in the member’s personal postage account
Cheques/money orders: Make payable to Ostomy Association of Melbourne Inc and write the
member’s name clearly on the back.
Bounced cheques will incur a charge of $20
Bank transfers, direct deposits and BPAY will not be accepted
The balance of a member’s postage account is shown on the packing slip/address label that ships
with the parcel
Annual Fees
Due each year in June. They may be paid earlier if desired.
Donations
As a not-for-profit organization we welcome donations. Donations over $2.00 are tax deductible.
Holiday Supplies
Members may request a two-month issue once per year, usually for a holiday. For example, April and
May’s supplies may be collected in April and the next order placed in June.
Holiday supplies must be pre-ordered in writing and clearly marked “Holiday Supply”
The postage cost of a two-month issue is $15
Holidays requiring issues greater than two months or more than once per year must be accompanied
by a copy of the member’s travel itinerary.
Belts, Underwear and Support Garments
We cannot exchange belts, underwear or support garments, nor can we advise on sizing. Garments
should only be ordered on the specific advice of a stomal therapy nurse.
Stomal Therapy Nurse
Members may visit our stomal therapy nurse free of charge by appointment only
Hours: Tuesdays and alternate Thursdays 8.30am to 3.00pm
www.oam.org.au