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

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Dose Delivery Day Order Deadline by Day and Time Zone* ET CT MT PT
Monday Wednesday 3pm 2pm 1pm 12 noon
Tuesday Wednesday 3pm 2pm 1pm 12 noon
Wednesday Thursday 3pm 2pm 1pm 12 noon
Thursday Thursday 3pm 2pm 1pm 12 noon
* All times are week prior to delivery

Quantity Item Number Item
SIR-Y001 SIR-Spheres Y-90 resin microspheres
(including 1 Accessory Pack*)
SIR-V001 V-Vial
SIR-D001 Delivery Set
SIR-H001 V-Vial Holder
SIR-S001 Syringe Shield
SIR-B001 Delivery Box
* Accessory pack includes: 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

Revision #5 (CR 2428) Issued 20 Sep 2018

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