|NOTE: Please set ALL Margins at 0.50", Print Out, Fill Out, SIGN and Send To:|
TOTAL HEALTH ASSOCIATES or
P.O. Box 9872
Columbus, OH 43209-0872
TOTAL HEALTH ASSOCIATES|
774-D S. Chesterfield Rd.
Columbus, OH 43209-2683
Please accept my Order for __ BioTec2000 Frequency Instrument(s) &/or __ BioTec2000 Ray Tubes Unit(s). I understand, if I decide to return either or both units for a REFUND, that they must be returned in the SAME Condition in which it/they was/were received and that a 25% Restocking Fee will be DEDUCTED from your REFUND.
I'm enclosing: $__________ (DISCOUNT Price) + $__________ (2nd Day Air U.P.S., if applicable - see below) = $__________ (TOTAL Amount - please insert in the AMOUNT window on the ORDER FORM.
I hereby AGREE to the above and the following Terms and Conditions:
Signature + Name (print clearly) Date