CHOLESTEROL CONTROL ORDER FORM
Description | No. | Total |
Chemcard Test Kit (contains 2 tests and 2 lancets), $19.00 If more than 9, see the Discounts page. |
$ | |
Package of 2 extra lancets, $1.00 (not counted as a foreign postage "item.") | $ |
Postage to countries outside the US. Add $12 to cover the outrageous postal rates. | $ |
Total. | $ |
Name: |
Address 1: |
Address 2: |
City: |
State (if used): |
Postal Code: |
Country: |
Email (will be kept private): |
Telephone (will be kept private): |
Date: |