Dr. Orman's Hgh Plus Order Form



For those who wish to pay via Check or Money Order, please print this page and mail with payment.



Name:__________________________________________________

Mailing Address:_________________________________________________

City:__________________ State:______ Postal Code:_________

Phone:________________

Number of Bottles:_________

1 bottle = $69



3 bottles = $189*



6 month Auto ship = $60/mo.*



12 month Auto ship = $53/mo*



24 month Auto ship = $45/mo*





* = Additional benefits included. The above costs include shipping and handling.

Special Instructions:___________________________________________



Please make checks payable to:

Dezine Management Inc.

Attn: Order Dept, Lisa

661 Huntington Pines Dr.

Ocoee, FL 34761 USA









Thank you for your order.