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Customer E-Mail
Important: Enter a valid e-mail address. Receipts and shipping info will be sent to this address.
*E-MAIL:
Prices Per Pill/Unit - All Drugs Below Are Generic
Use As Many Forms As Needed To Complete Your Order - Shipping Will Be Adjusted As One Order
Drugs starting with A:
Drugs starting with B
Drugs starting with C
Drugs from D and E
Drugs - F-G-H
Drugs - I-J-K-L
Drugs - M-N-O
Drugs starting with P
Drugs - Q-R-S
Drugs -T-U-V-W-X-Y-Z
Sub-Total:
*Shipping & Handling:
Grand Total:
Billing Information
*First Name:
*Last Name:
*Address Line 1:
Address Line 2:Apt. or Suite No.
*City:
*State/Prov:
Other County/State/Prov
*Country:
*Zip/Postal Code:
*Phone:
Shipping Information
Same As Billing Info
First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State/Prov:
Other County/State/Prov
Country:
Zip Code:
Required Payment Is U.S. Dollar Money Order
We are no longer able to accept or process visa and master card credit cards.

Visa and MasterCard are terminating merchant account agreements with businesses that service the online pharmaceutical industry.

Once you submit this order form, the order will be reviewed and an email will be sent to you to containing the order information, which can be printed out and mailed with your money order payment.

In the email you will receive the mailing address to which you can mail your order with a money order payment in U.S. dollars.

If you are unable to print out the order you can just write your name and the original order date on the money order.

As soon as payment is received you will be notified and given an order ID number. The order will then be queued for processing with the pharmacy.
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