ORDER FORM

TOTAL HEALTH ASSOCIATES
774-D S. Chesterfield Rd.
Columbus, OH 43209-2683
Sales Mgr. - Tom Harrelson
Sales & Info/614-237-2590/W
Sales & Info/614-596-8530/C

Name:                                                                                   Date:
Address:
City:                                                               State:                                ZIP:
Country (if applicable):                               Email Add.:
Phone (Day.):                                               Phone (Eve.):

NOTE:  Before you place your Order, please read and understand the GENERAL TERMS & CONDITIONS, plus the NOTICE & DISCLAIMER. If the TOTAL Amount of your Order is LESS than $30 and you send me a Personal Check, Company Check &/or M.O. or your Order is $30 or MORE and you send me a UNITED STATES POSTAL SERVICE Money Order (NOT Bank or ....), then your Order will be shipped the Next Day, after I receive it, unless otherwise notified. Please send your Order by Priorty Mail/Signature Confirmation for Orders, which amount to $100 and over. If the TOTAL Amount of your Order is $30 or MORE and you send me a Personal Check, Company Check, Cashier's Check &/or a regular M.O., then your Order will be shipped within 3-5 Business Days, unless otherwise notified. Since I'm NOT ABLE to accept Charge Cards or C.O.D. Orders at this Time, you can take 10% or MORE OFF from the Retail Price (see Price List), unless you're purchasing a REFURBISHED Unit. If your Healing Tool(s) must be shipped outside of the U.S., then please email me (tharrels@hotmail.com) or call me (614-237-2590). "THANKS" for your Order!!

YOUR NOTE:



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ITEM NAME/DESCRIPTION
UNIT EA./$
TOTAL/$
       
       
       
       
TOTAL Amount - TOTAL/$
SUBTOTAL
 
Subtract Discount (see PRICE LIST)
DISCOUNT
 
TOTAL Amount
SUBTOTAL
 
Add Amount From Another ORDER FORM (if applicable)
AMOUNT
 
TOTAL Amount
TOTAL
 
2nd Day Air Shipping Cost (if applicable)
AMOUNT
 
TOTAL Amount
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