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Order Forms

Attention: Before sending this order, make sure your organization is registered with PROMESS (refer to the procedures for registration at the Ministry of Health).

If your organization is registered with PROMESS, you have 2 options:

  1. Complete and send these order forms (Documents A and B or documents A and C in case of cholera) by e-mail, we will reply as soon as possible to communicate the cost and preparation time. When your order is ready for pick up at PROMESS, please bring Document A of this order, with the stamp of the institution or organization, and the original signature of the responsible person and your products will be delivered.

  2. Print these order forms (Documents A and B or documents A and C in case of cholera), fill it out, with the seal of your organization and the signature, then bring it to PROMESS. You may wait while your order is being filled.

Note 1:
  You may use the form (Document B) to calculate the cost of your order, BUT do not prepare the check in advance as it is possible that quantities of certain products may be changed depending upon availability.In the case of cholera-specific products (Document C) there is no charge.

Note 2 (for non-cholera products): the list sorted by therapeutic classification can help you select the products required. Note the required quantities on the order form (Document B) itself (where the products are ordered alphabetically).

Order Form



No. 295 Avenue John Brown, Port-au-Prince, Haiti,
Boite Postale 1330, Port-au-Prince, Haiti
Tel.:+509 28143000
Fax:+509 28143089 email