WiSSP Order Form

Wisconsin Stillbirth Service Program
Request to Order

We are not equipped to accept orders through this Website or by email. Please download this form and mail to:

Peggy Modaff, M.S.
Wisconsin Stillbirth Service Program
University of Wisconsin Clinical Genetics Center
Waisman Center, Room 343
1500 Highland Avenue
Madison, WI 53705-2280

Date:

Deliver to:

Method of Payment:

Check or money order enclosed (payable to Wisconsin Stillbirth Service Program)
Bill me (must include Requisition or PO number)
Financial contact person:
phone:
Address:

Req./P.O. Number: (must be supplied for non-prepaid orders):

  Unit Price Quantity PRICE

When the Least Expected Happens -

A pamphlet for the general public. single copies:

per 10:

per 100:



$0.50

$3.50

$25.00

   

When Your Baby is Stillborn -

A pamphlet for parents. single copies:

per 10:

per 100:



$0.50

$3.50

$25.00

   

Life and Death Before Birth -- Evaluation of the Stillborn

Video Series with Users’ Manual per set:



$90.00

   

The following items are contained in the Users' Manual but can be ordered separately:

Stillbirth Assessment Protocol. single copies:

per 10:

WiSSP Annotated Bibliography. single copies:

per 10:




$3.00

$25.00

$2.00

$15.00

   

WiSSPers Newsletter Subscription. annually:

$8.00

   

Packet of 6 WiSSP Authored Scientific Publications -
The Wisconsin Stillbirth Service Program: I. Establishment
and assessment of a community based program for etiologic
investigation of intrauterine deaths,
1994; The Wisconsin
Stillbirth Service Program: II. Analyses of diagnoses and
diagnostic categories in the first 1000 referrals.
1994;
Validation of radiographic criteria for the diagnosis of
Down syndrome in stillborn infants,
1997; Lower
mesodermal defects - a common cause of fetal and early
neonatal death,
1994; Fetal disruptions: Assessment of frequency,
heterogeneity and embryologic mechanisms in a population
referred to a community-based stillbirth assessment program,
1990; Accuracy of fetal death reports: Comparison with data
from an independent stillbirth assessment program,
1987.

$4.00

   

TOTAL (ALL PRICES INCLUDE POSTAGE):

    $

Educational Resources
For Parents, Families, and the Public
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