ICD10 ORDER FORM

By completing this Order Form you are supplying us with an
Order Confirmation for “Dental Diagnostic Code Manager” Version 2.11


Number of dentist in practice?
Name(s) of dentist ordering Code Manager?
E-mail address to Confirm Order / send download Password to?
Do you need a CD?
Postal address for mailing CD
Contact Person at Practice?
Fax + Tel + Code?
Your practice VAT No?
What practice software are you running?
Your Practice Registration No?
If Member of ORALnet, supply member Number
Message / Notes


SADA Members	R760*
ORALnet Members-	R650*
ORALnet Members + Exact Software Users	R550*
* = VAT included
Dental Diagnostic Code Manager is downloaded from this website. If you require Code Manager to be posted to you on a CD, please add R 50-00 to your payment.
Terms & Conditions Dental Diagnostic Code Manager is... 1. Supplied in electronic format only. 2. Sent via password protected e-file only - With clear install instructions. 3. Is personalized per dentist/ practice- Each dentist / practice obtains his/ her own copy per Practice Reg no. 4. Version updates are via e-mail notification-free of charge for 12 months 5. Information about the ExACT Institute is found at www.exact-net.com 6. The ICD-10 code system: Copyrighted + licensed by World Health Organization 7. The SADA code system: Copyrighted + licensed by South African Dental Association
Thank you for you Order On confirmation of receipt of your payment, your Download Instructions and Password will be e-mailed to you or, your installation CD will be posted to you within 3 working days.

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