Institute for Better Health

Print this form to fax or mail your order

Fax completed form to: (702) 242 0035
- or -
Mail completed form with check or money order to:
The Institute for Better Health
Institute for Better Health, 1512 Fremont St., Las vegas , Nv. 89101

Name
Address
City
State/Zip
Email
Card Type (circle one)	Visa Master Card American Express
Card Number
Exp. Date
Name (as it appears on card)
Billing Address
City
State/Zip
Phone
Email
How did you find us?
What Search Engine did you find us?

QUANTITY	ITEM	UNIT COST	TOTAL COST

SHIPPING	S&H $10.00/ Priority Mail $20/Outside U.S. $30 (combination 3 & 4)
SHIPPING	S&H $6.50/ Priority Mail $12.50/Outside U.S. $20
TOTAL
SIGNATURE

6 month money back guarantee if you are not completely satisfied
©1999-2003 Institute for Better Health. All Rights Reserved Worldwide
IFBH in no way suggests that any products it sells are a cure for any disease or pathology.