Indium for Life Inc - ORDER FORM


Order detail

Indium APW 1/2 oz ................. Qty ________ Sub-total $ __________

Indium APW 1 oz w/atomizer ........ Qty ________ Sub-total $ __________

Free sample ($8 shipping) ......... Qty ________ Sub-total $ __________

Multiplex II 60 tablets ........... Qty ________ Sub-total $ __________

Bio Trace ......................... Qty ________ Sub-total $ __________

Cytolog 5oz spray ................. Qty ________ Sub-total $ __________

Velvet Antler 250mg 90 capsules ... Qty ________ Sub-total $ __________

Mezotrace 240 tablets ............. Qty ________ Sub-total $ __________

Priority Mail ..................... Qty ________ Sub-total $ __________

.................................................... Total $ __________

Shipping address/contact

Name _______________________________________________________________

Address ____________________________________________________________

City __________________________________ State ______ Zip ___________

Phone ______________________ Email _________________________________


Method of payment (payable to Essential Health, INC.)

____ Check ____ Money order ____ Credit card







Mail to Essential Health, Inc.
PO Box 1343
Morrisville, PA 19067-0343



fax: 435-514-5239 orders: 800-737-6509 questions: 435-514-5239





Indium for Life Inc - PRICE LIST









Credit card information (if applicable)

Credit card type _________________

Credit card number ______________________________ Exp Date _________

Name ____________________________________ Phone ____________________

Address ____________________________________________________________

City __________________________________ State ______ Zip ___________

Your signature _____________________________________________________

































fax: 435-514-5239 orders: 800-737-6509 questions: 435-514-5239












Indium for Life Inc - PRICE LIST

Item ......................... Qty ...... Price ................ Amount
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Indium APW 1/2 oz .............. 1 ...... $23.00 ............... $23.00

Indium APW 1/2 oz .............. 2 ...... $21.00 ............... $42.00

Indium APW 1/2 oz .............. 3 ...... $19.00 ............... $57.00

Indium APW 1/2 oz ..............12 ...... $16.00 .............. $198.00

Indium APW 1/2 oz ............. 24 ...... $12.00 .............. $288.00
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Indium APW 1 oz ................ 1 ...... $45.00 ............... $45.00

Indium APW 1 oz ................ 2 ...... $38.00 ............... $76.00

Indium APW 1 oz box of 12 ...... 6 ...... $32.00 .............. $198.00

Indium APW 1 oz 5 boxes ....... 12 ...... $24.00 .............. $288.00
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Multiplex II 60 tablets ........ 1 ...... $27.00 ............... $27.00

Multiplex II 60 tablets ........ 2 .......$25.00 ............... $50.00

Multiplex II 60 tablets ........ 3 .......$23.00 ............... $69.00
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Bio Trace 60 tablets ........... 1 ...... $35.00 ............... $35.00

Bio Trace 60 tablets ........... 2 .......$33.00 ............... $66.00

Bio Trace 60 tablets ........... 3 .......$31.00 ............... $93.00
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Cytolog 5oz .................... 1 ...... $35.00 ............... $35.00

Cytolog 5oz .................... 2 .......$33.00 ............... $66.00

Cytolog 5oz .................... 3 .......$31.00 ............... $93.00
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Velvet Antler 250mg, 90 caps ... 1 ...... $32.00 ............... $32.00

Velvet Antler 250mg, 90 caps ... 2 .......$30.00 ............... $60.00

Velvet Antler 250mg, 90 caps ... 3 .......$28.00 ............... $84.00
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Empty atomizer bottle .......... 1 ....... $2.00 ................ $2.00
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fax: 435-514-5239 orders: 800-737-6509 questions: 435-514-5239




Indium for Life Inc - PRICE LIST

Item ......................... Qty ...... Price ................ Amount
-----------------------------------------------------------------------
Mezotrace 240 tablets........... 1 ...... $19.00 ............... $19.00

Mezotrace 240 tablets........... 2 ...... $17.00 ............... $34.00

Mezotrace 240 tablets........... 3 ...... $15.00 ............... $45.00
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Indium (sample) ................ 1 ....... $8.00 ................ $8.00
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Priority Mail ................................................... $5.00