ORDER FORM PAGE

Pathways To Healing TM Product Order Form

HOW TO ORDER

To place an order, simply fill out the form below. Once completed there are
various ways to submit. If paying by check or money order, print this form
and send it to the address on the bottom, along with your payment. If you wish
to pay by credit card in this site , fill in the card information and press the submit order button below, or if you prefer you can fax or call in your order.

Office hours (M-F, 9am - 5pm EST) 1-305-792-9090
Fax (24 Hours Daily) 1-305-792-9020

Please provide the following contact information:

First name

Last name

Street address

Address (cont)

City

State/Province

Zip/Postal code

Country

Work Phone

Home Phone

FAX

E-mail

Shipping Information (ifdifferent than above)

Ship to address :

City: State:Country:

Zip Code:

NON CREDIT CARD:

Check
MoneyOrder

1-305-792-9090 ......FAX:1-305-792-9020

Billing
Information:

Credit card

Cardholder

Card number

Expiration date

Tapes to Order


Stress..$19.95


Think.Slim..$19.95


Surgical.Anxiety..$19.95

Great.Sex.for.Him..$19.95

Great.Sex.for.Her..$19.95

Any2 Tapes........$37.95

Any3 Tapes.......$54.95

Any4 Tapes.......$69.95

Any5 Tapes.......$82.95

Add Shipping and Handling at $5.95

On International orders

International rates apply

Florida Residents will be charged 7% Sales Tax

Volume Discounts

Available

call or fax for pricing.

1-305-792-9090 ......FAX: 1-305-792-9020

Mail To:

Pathways To Healing TMInc.,

P.O. Box 3775,

Hallandale, Florida 33008