Buy INTIMACY with IMPOTENCE: The Couple’s Guide to Better Sex after Prostate Disease

To order the books, fill out the secure form below and click submit (for help call 301-983-9702) You may also click here to print out a mail/fax form.

STEP 1: ORDER AND DONATIONS
I would like copies of the book Copies of the book *INTIMACY with IMPOTENCE: The Couple’s Guide to Better Sex after Prostate Disease* ($14.00 US only plus $4.00 shipping) (International Shipping is $13.00 and includes Canada and Mexico)
I would like copies of the book A Patient's Guide: Urinary Incontinence Control using External Urethral Compression Devices (Clamps) ($14.00 US only plus $4.00 shipping) (International Shipping is $13.00 and includes Canada and Mexico)
I would also like to included a tax deductable contribution: $20 \| $35 \| $50 \| $100 \| $500 \| OTHER $

STEP 2: CONTACT INFORMATION
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STEP 3: PAYMENT CHOICE
Pay by	check or money order (mailing address will appear after you hit the Submit Button below) -- OR -- PayPal
	If you want to ship the book(s) to a different address, indicate in the notes field below. After your press the submit button, TO COMPLETE YOUR PAY BY CHECK ORDER SEND YOUR CHECK TO: CIACT, P.O. Box 341388, Bethesda, MD 20827-1388 Phone: 301-983-9702 - Make check payable to: CIACT (This information is also on your confirmation page and confirming email)

STEP 4: HOW HEARD AND NOTES
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STEP 5: EASY DONATION OPTION
I would like pay $25 per book (includes shipping) and make a $7 per item tax deductable donation to CIACT.

STEP 6: SEND ORDER/DONATION
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