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Visit our Retail Store
120 Route 110
Farmingdale, NY 11735

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Total Health Order Form
www.totaldiscountvitamins.com 1-800-283-2833
Mail To: Total Health, 120 Broadhollow Rd Ste 1, Farmingdale, NY  11735 (make checks payable to "Total Health")
Fax ToSeven Days a Week 24 Hrs a Day to (631) 293-3009
ORDERED BY AND SHIP TO:

Name:_______________________________________________________________________

Street address:_________________________________________________________________

City:_____________________________________ State __________Zip____________________

Day phone:___________________ Evening Phone ___________________ E-Mail:______________________

 Cat#  Qty.  Product & Size  Price Each  Total
        $
        $
        $
        $
        $
        $
        $
        $
        $
Additional Postage:
  • UPS Second Day Air $15.95 (contiguous 48 states - 5 lb max - does not include Hawaii, Alaska or Puerto Rico)
  • UPS Saturday Delivery - $28.45 (contiguous 48 states - 5 lb max - does not include Hawaii, Alaska or Puerto Rico)
  • UPS 3 Day Select - $9.95 (contiguous 48 states - 5 lb max - does not include Hawaii, Alaska or Puerto Rico)
  • Alaska, Hawaii or Puerto Rico $8.95 (USPS Priority)

Subtotal

 $

Shipping and Handling

$6.95

Additional Postage

 $

Total

 $

Method of Payment: check______ Visa_______ Master card_____ Discover_____

Credit Card Acc# _________________________________________________ exp. date__________

for credit cards please Sign X__________________________________________________________

CCID#:_________________ For your protection, we ask that you enter an extra 3-4 digit number called the CCID. (It may also be referred to as a CVV2 or CVC2 code.) The CCID is NOT your PIN number. It is an extra ID printed on your Visa, MasterCard, Discover, or American Express Card.
Visa, MasterCard, and Discover: On the back of the card in the top-right corner of the signature box. Enter the three-digit number following the credit card number.
American Express: On the front of the card. Enter the four-digit number on the right directly above the credit card number.


ORDERING INFORMATION - E-mail for Overseas Rates or see International Shipping Rates

If you have any question or would like to place an order, call Total Health seven days a week M-F 9am to 8pm Sat/Sun 9am to 6pm (EST). Our friendly staff are here to serve you, just call our toll free 1-800-283-2833 or (631) 293-3001. For orders on Visa, Master Card or Discover, have your card number, expiration date and ccid# ready.

To order by mail: Print this form. Please provide all information. Payment can be made with personal check*, money order, or credit card.

Personal checks-allow 10 business days to clear. Make Checks payable to Total Health Inc. Not responsible for typographical errors. Total Health reserves the right to substitute products of equal or greater value.

If you would like to mail in order form our address is as follows: Total Health, 120 Broadhollow Rd Ste 1, Farmingdale, NY 11735

Non US orders will be quoted on an order by order basis - please e mail for quote

Import restrictions, fees, duty, tariffs, and or taxes will be the responsibility of the purchaser.




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