WAVESHAPER™ Frequency Instrument
SPECIAL ORDER FORM

NOTE: Please set ALL Margins at 0.50", Print Out, Fill Out, SIGN and Send To:

TOTAL HEALTH ASSOCIATES
774-D S. Chesterfield Rd.
Columbus, OH 43209-2683
Sales&Info/614-237-2590

Please accept my Order for __ WAVESHAPER™ Frequency Instrument. I understand that, if I am NOT satisfied with my purchase, the WAVESHAPER™ Frequency Instrument has a 30 day MONEY-BACK Guarantee. I also understand that, if I'm returning one or MORE Units, they must be returned in SALEABLE Condition and that there will be a 15% Restocking Fee.
NOTE: ANY Unit, which has been DAMAGED, TAMPERED with &/or which has had it's Case OPENED, is NOT RETURNABLE.

I'm enclosing: $__________ (DISCOUNT Price - please see PRICE LIST) + $__________ (2nd Day Air U.P.S., if applicable - see below) = $__________ (TOTAL Amount - please insert in the AMOUNT window on the ORDER FORM, and also use that Form, if ACCESSORIES &/or additional Healing Tools are being ordered).
NOTE: Please send a U.S.P.S. Money Order or Cashier's Check for NEXT Day Shipping. Company or Personal Checks take about 3 days to CLEAR. CASH will ONLY be accepted in Person. Please ADD $15 for 1 - Unit & $25 for 2 - Units above, if you NEED to have 2nd Day Air U.P.S. Delivery.

I hereby AGREE to the above and the following Terms and Conditions:
I, the undersigned, hereby declare that I am NOT ordering on behalf of a Government Agency for the purpose of ENTRAPMENT or otherwise. I am purchasing the WAVESHAPER™ Frequency Instrument for one or MORE of the following Purposes ONLY: Experimentation, Testing, Educational, Technical, Veterinary Work, Relaxation, Meridian Balancing &/or Energy Charging.

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