Reneuvo - Help for Thinning Hair, Baldness and Aging Skin

		Order Form
\| home \| hair reneu \| skin reneu \| softbeam rejuvenator \| skin rejuvenation \| special offers \| contact us \|

ORDERING IS SIMPLE
NEED HELP - CALL
1.888.685.4247

Complete the below secure order form to place your order electronically. A confirmation will be mailed detailing receipt of order, charging of credit card and tracking information.

- or -

Complete the below order form and instead of submitting it electronically print the page and fax it to 401.739.8095. A confirmation will be mailed detailing receipt of order, charging of credit card and tracking information.

- or -

Call your order in Toll Free at 888.685.4247 between the hours of 9:00a and 5:00p Eastern Time.

Qty	Description	Price Ea
SoftBEAM Rejuvenation At-Home
	SoftBEAM™ Rejuvenator (includes special offer discount) info	$249.00

Microdermabrasion At-Home
	Crystal Reneu At Home Microdermabrasion Peel info	$ 39.99

CelluLiteRX At-Home
	Step I - LipoSmooth Body Lotion info	$ 32.00
	Step II - LipoTherm Contour Cream info	$ 96.00
	CelluLite Kit - Steps I, II, and III info	$145.00

Healthy You At-Home
	Sprite Massaging Shower Head/Chlorine Filter info	$ 39.99
	Sprite Massaging Shower Replacement Filter Cartridge info	$ 18.99
	Sprite Massaging Shower Head/Filter w/ Extra Cartridge info	$ 56.49
	Step 1 Shampoo (6 Fl. Oz.) info	$ 9.95
	Step 2 Scalp Cleanser (6 Fl. Oz.) info OUT OF STOCK	$ 9.95
	Renewal Pillow Queen - Plush, 5'5" under, stomach/back sleepers info	$ 95.00
	Renewal Pillow King - Plush, 5'5" under, stomach/back sleepers info	$ 99.00
	Restora Pillow Queen - Firm, 5'6" over, side/back sleepers info	$105.00
	Restora Pillow King - Firm, 5'6" over, side/back sleepers info	$109.00

Shipping
	UPS Shipping Charge (first product)* REQUIRED FIELD	$ 7.50
	UPS Shipping Charge (all additional products)*	$ 1.50
TOTAL:

*If you are ordering one product, please add a 1 in the quantity box of the
UPS Shipping Charge (first product) field. For all additional items ordered
enter the number additional items selected (after the first item) in the quantity
box of the UPS Shipping Charge (all additional products) field. This will be
added to your total that will be charged to your credit card. All orders are
shipped via UPS Ground to the address detailed in the Shipping
Address you fill out in the form below. If ordering from Rhode Island 7% of
the Total will be charged to your credit card. - Thank You -

Credit Card Info

Credit Card Type: (required)

Visa
Mastercard

American Express
Discover

Credit Card Number: (required)

Card Expiration: (required)

Security Code:

Name on Credit Card: (required)

Address (where bills go): (required)

Address2

City, State, Zip (required)

Phone (with area code): (required)

Email: (required)

Shipping Address

Same as Credit Card Address (can't be PO Box)

Name:

Company:

Address:

Address2:

City, State, Zip

Comments:

INSTRUCTIONS

ELECTRONIC ORDER - Press the "SUBMIT" button above to place your order securely and electronically.
ORDER BY FAX: You may submit your order via fax by filling in all the information above (securely)and then faxing it to 401-739-8095. Simply DO NOT press the submit button and none of your information will be transmitted electronically.
ORDER BY PHONE: Use the above form as a guide/reference and call our toll free order hotline at 888.685.4247 between the hours of 9:00a and 5:00p Eastern Time.

PLEASE PRINT THIS PAGE FOR YOUR RECORDS

If you would like to fax this order please print it, enter the
required information and fax it to 401.739.8095

Order Form