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Product Ordering

Online Order Form - Middle-East and Africa

Thank you for using the Sirtex Online Order Form.

Please complete the fields below to place your order. By entering your account number, you will be able to see the delivery options available for your center.

After your order has been processed, you will receive an order confirmation from Customer Service.

Cancellation Policy: If your order of SIR-Spheres® Y-90 resin microspheres needs to be cancelled after order deadline, please advise Sirtex Customer Service as soon as possible by email at cs-eu@sirtex.com.

Receipt of your cancellation will be confirmed by Sirtex.

If you have any questions or do not know your account number, please email cs-eu@sirtex.com or call us at +49-228-1840-730.

SIR-Spheres® Y-90 resin microspheres Online Order Form - Middle East and Africa



Delivery Information



Treatment Site Information


Distributor Information


(The values you enter above will be saved to a cookie in your web browser. The information will automatically expire after 90 days.)

Order Information


Order Deadline Flight Arrival Day
(flight availability depending on the destination. Check with Sirtex CS.)
Calibration Day Pre-Calibration Activity
(assuming one day Customs clearance)
Treatment Day
Tuesday
4pm CET
the preceding week
Sunday Thursday 3 days
2 days
1 day
0 day
+1 day
Monday
Tuesday
Wednesday
Thursday
Friday
Thursday Saturday 1 day
0 day
+1 day
Friday
Saturday
Sunday

Quantity Item Number Item
SIR-Y001 SIR-Spheres Y-90 resin microspheres
Each dose may include a maximum of four (4) accessories packs (SIR-K002)
which contains one (1) Delivery Set, one (1) V-Vial and one (1) V-Vial Holder. Please order accordingly,


SIR-K002 Gen 1 Accessories Pack
(Gen 1 Delivery Set, Gen 1 V-Vial and Gen 1 V-Vial Holder)
Max. four (4) packs per dose
SIR-S001 Syringe Shield
Reuseable item: Please state reason for ordering
SIR-B001 Gen 1 Delivery Box
Reuseable item: Please state reason for ordering
-
Other, please specify:
SIR-10100 SIROSTM Delivery Dome
Reuseable item: Please state reason for ordering
SIR-10200 SIROSTM D-Vial Prep Set
Shipped seperately from SIR-Spheres dose
SIR-10300 SIROSTM Delivery Set
Shipped seperately from SIR-Spheres dose
SIR-H001 V-Vial Holder

Notes


* mandatory field




SIR-Spheres® is a registered trademark of Sirtex SIR-Spheres Pty Ltd.

Form 915e
Reference: QSOP06
280-E-1019

Revision # 0 (CR 2579) Issued 05 Nov 2019

SIR-Spheres® Y-90 resin microspheres are indicated for the treatment of unresectable hepatocellular carcinoma (HCC) or unresectable metastatic liver tumors from primary colorectal cancer (mCRC) in patients refractory to or intolerant of chemotherapy.

SIR-Spheres® is a registered trademark of Sirtex SIR-Spheres Pty Ltd.