Sorry, I thought I had included this, thanks for the nicotine patc=
h=20
suggestion. Linda Forrests Mom

Chronic Wellness International Off-line Order Form



-print and fill out the below order form and fax, phone or mail in yo=
ur
order or click here for secure credit card orders.=20
Product Description - from belowUnit
PriceQtyTotal....................Subtotal:.Tax on Subtotal (CA
Only)7.75%.Shipping & Handling Charge TableS&H - US and Canada



S&H - outside the US and CanadaIf the subtotal is:
under $65 -=20
between $65 and $120 -=20
above $120 -=20
any amount - S&H Charge
$5.00
$7.00
$10.00
$12.50S&H Charge:___________Total:___________ Your Ship to address:=
=20

Name:______________________________=20

Address:____________________________=20

City: _________________________, State: __________ Zip: _____________=
__=20

Phone No: _____________________________ Card Type (circle one): MC, V=
isa,
AmEx, Disc=20

Credit Card # ________________________________ Exp. _____/_____=20

Name (as it appears on the credit card) ___________________________=
=20

Signature ____________________________________=20

email: _______________________________ (for order confirmations and p=
roduct
updates)
Please make checks or money orders out to Chronic Wellness Internatio=
nal
Would you like to be on our electronic newletter mailing list?
Yes/No - We will need an email address for this.=20

Health Issues:

Please mail, fax or phone in your order to:=20
Chronic Wellness International, 1360 Timber Glen, Escondido, CA 92027
Phone: 619-739-0580 Fax: 619-735-6383, [log in to unmask] Plea=
se
allow 1-2 weeks for delivery.
Home, SecureOrder Form - Secure transactions for Credit Card and Chec=
k orders

Product Details - Usage Recommendations, Ingredients, Servings per
Containter (size: 77K)=20
Product Name - How long 1 bottle lasts under normal usage Price Acido=
philus
Plus Colostrum=99 - a 3 month supply $31.50 Candida Zyme=99 - a 3 mon=
th supply
$25.13 LiquidLightning CLO2=99 - a 6 to 9 month supply $28.50 LiquidL=
ightning
Essiac=99 - a 3 to 6 month supply (reduced from $46. 50!!) $38.50
LiquidLightning Meta-D-10 (colloidal DHEA)=99 - a 3 to 6 month supply=
 $55.50
LiquidLightning N-Acetyl Cysteine=99 - a 3 to 6 month supply $28.50
LiquidLightning NADH=99 - a 3 to 6 month supply $37.50 Sagrada Plus=
=99 - enough
for a 2 week cleanse $23.63 Complete Cleanse Starter Program - a 6-8 =
week
program
Includes: 1ea of the Sagrada Plus=99, Candida Zyme=99 and Acidophilus=
 Plus
Colostrum=99 the LiquidLightning colloids of Essiac=99, CLO2=99, N-Ac=
etyl
Cysteine=99 : Normally $183.75 Save 10% off buying each separately $1=
65.38 The
Essiac Report=99 (book) $19.95=20

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Copyright =A91996 by Chronic Wellness International=99=20

Last Updated 11/03/96=20