Natural Medical Protocols - program order form

Order Form

Shipping Name and Address (* = required field):
*First Name:
*Last Name:
Address Line 1:
Address Line 2:
City:	State:
Zip/Postal Code:	Country:
*Telephone Number:
*Email:
Credit Card Number:	Exp. Date:
Student/conference code (if any):
This is a yearly renewal - I subscribed last year (take $60.00 off).
Send a CD to install Natural Medical Protocols on a PC in addition to access over the Internet (add $8.00 for shipping and handling).
Your credit card will be charged $240.00 (plus $8.00 if a CD is to be sent and minus $60.00 if this is a yearly renewal). Or, call us at (203) 264-7246 to place your order if you prefer.


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