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. If you have any questions, please email csusa@sirtex.com or call us on one of our numbers listed on our Contact page.

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

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


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Deadlines




Delivery Day Monday Tuesday Wednesday Thursday Friday
# Days pre-cal 3 day
(Thursday)
7.28 GBq
3 day
(Friday)
7.28 GBq
3 day
(Saturday)
7.28 GBq
3 day
(Sunday)
7.28 GBq
3 day
(Monday)
7.28 GBq
2 day
(Wednesday)
5.61 GBq
2 day
(Thursday)
5.61 GBq
2 day
(Friday)
5.61 GBq
2 day
(Saturday)
5.61 GBq
2 day
(Sunday)
5.61 GBq
1 day
(Tuesday)
4.33 GBq
1 day
(Wednesday)
4.33 GBq
1 day
(Thursday)
4.33 GBq
1 day
(Friday)
4.33 GBq
1 day
(Saturday)
4.33 GBq

Quantity Item Number Item
SIR-Y001*
SIR-Spheres Y-90 resin microspheres
SIR-K002 Accessories Pack (includes 1 Delivery Set, 1 V-Vial and 1 V-Vial Holder)
SIR-V001 V-Vial
SIR-D001 Delivery Set
SIR-H001 V-Vial Holder
SIR-S001 Syringe Shield
SIR-B001 Delivery Box
* Each SIR-Y001 includes: an accessories pack SIR-K002 (ONE (1) Delivery Set, ONE (1) V-Vial, ONE (1) V-Vial Holder) and shipping




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

Form 910E
Reference: QSOP06
173-U-0419

CAUTION: Federal law restricts this device to sale by or on the order of a physician or licensed healthcare practitioner.

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