MAIL - FAX ORDER FORM

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Then please fax to xxx.xxxxxxx

From : Date :

Description		Quantity	Price	Total
	Percutane™ (45g Pot)		4.99
	Percutane™ (100g Pot)		9.99
	THERMASTRAP Adjust-a-Cup (Ankle & Foot)		9.95
	THERMASTRAP Arm & Elbow		9.99
	THERMASTRAP Back		15.99
	THERMASTRAP Calf & Shin		8.95
	THERMASTRAP Knee		14.95
	THERMASTRAP Multi-purpose strap		29.95
	THERMASTRAP Neck		7.99
	THERMASTRAP Thigh & Hamstring		6.99
	THERMASTRAP Wrist & Hand		8.99
SubTotal	[1. click in box for sub-total]
Shipping	[2. click in appropriate box] - 5 items or less more than 5 items
TOTAL	[3. click in box for grand total]

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All prices are in GB Pounds
Nuexcom Guarantee:- If for some reason your are not completely satisfied with any of our products, simply return it to us within 30 days of purchase and we will gladly refund your money in full.
Please note that shipping and handling costs are not refundable.