Thank you for using the Sirtex Online Order Form. Please complete the fields below to place your order. After your order has been processed, you will receive an order confirmation from Customer Service.

Cancellation Policy: If your order of SIR-Spheres microspheres needs to be cancelled after order deadline, please contact your sales representative at your earliest convenience.

If you have any questions, please email cs-eu@sirtex.com or call us on +49-228-1840-730.

 

SIR-Spheres® Y-90 resin microspheres Online Order Form



(if you don't know your account number email cs-eu@sirtex.com)


Delivery Information


Treatment Site Information



Distributor Information (if applicable)


What's this?


Order Information



Delivery Day Mon Tues Wed Thurs Fri Sat Sun
# Days pre-cal 4 day (Mon)
3 day (Mon)
2 day (Wed) 2 day (Mon)
1 day (Tues) 1 day (Wed) 1 day (Thur) 1 day (Mon)
0 day (Mon) 0 day (Tues) 0 day (Wed) 0 day (Thurs)
1 day (Mon) 1 day (Tues) 1 day (Wed) 1 day (Thurs)


FLEXdose Delivery Programme

Deadline (Orders must be to submitted to CS no later than) Calibration Day Delivery Day Treatment Days
(before/on/after Calibration in days)
Monday 5pm Monday Thursday
Friday
Saturday
Sunday
or
Monday
Thursday (+4)
Friday (+3)
Saturday (+2)
Sunday (+1)
Monday (±0)
Tuesday (-1)
Wednesday 5pm Tuesday Monday
or
Tuesday
Monday (+1)
Tuesday (±0)
Wednesday (-1)
Wednesday Monday
Tuesday
or
Wednesday
Monday (+2)
Tuesday (+1)
Wednesday (±0)
Thursday (-1)
Friday 5pm Thursday Wednesday
or
Thursday
Wednesday (+1)
Thursday (±0)
Friday (-1)

Quantity Item Number Item
SIR-Y001 SIR-Spheres® Y-90 resin microspheres
(Standard activity per dose: 3 GBq +/- 10% at day of calibration 23:00 GMT)
Refer to SIR-Spheres Y-90 resin microspheres Dose Calibration and Delivery Schedule here
SIR-K002 Accessory Pack
(Delivery Set, V-Vial and V-Vial Holder)
Max. three (3) packs per dose
SIR-S001 Syringe Shield
Reuseable item: Please state reason for ordering
SIR-B001 Delivery Box
Reuseable item: Please state reason for ordering








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

Form 904e
Reference: QSOP06
296-E-1019

Revision #1 (CR 2591) Issued 11 Nov 2019

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