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Product Pricing
Please print and send this order form upon completion!
ItemProductList PriceOrder
001 Holistic Health Software
49.95
002 Holistic Sampler
15.95
003 Vitamin & Supplement Software
29.95

Customer Information

Data RequiredPlease enter data
Your Email ID *
Company Name..........
Your full Name *
Address line 1 *
Address line 2........
City *
State or Province *
Zip or Postal Code *
Country...............
Phone number *
How did you find us?
Comments..............
* = Required Field

Credit Card Payment

Do Not Enter Credit Card information.
Print the form first and then fill it out before remitting.
Credit Card Type
American Express
Master card
Visa
Card Number
Expiration Date

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Payment by telephone

Please call RemedyGuides Inc. product sales at 800-713-2098. (330-342-4498).

Payment by FAX

Fax the printed form to RemedyGuides at 330-342-7343. We will fax back your access password.

Payment by check

Mail this printed form to: RemedyGuides Inc.; 4833 Darrow Rd Ste 106; Stow, Ohio 44224

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