Order Form

The OPTIMOX CORPORATION

OPTIMOX
PO Box 3378, Torrance, CA 90510-3378
Phone: 800 223-1601
Fax: 310 618-8748
www.optimox.com

 

CONSUMER ORDER FORM

 
OPTIVITE® PMT GYNOVITE® PLUS MAG-200 ATP COFACTORS ANDROVITE® FOR MEN
ProductPrice BreakdownQuantity

Total Cost

OPTIVITE® PMT
Bottle of 180 tablets
1-5 bottles $18.00/bottle
6-11 bottles $16.50/bottle
12+ bottles $15.00/bottle
   
GYNOVITE® PLUS
Bottle of 180 tablets
1-5 bottles $18.00/bottle
6-11 bottles $16.50/bottle
12+ bottles $15.00/bottle
   
MAG-200
Bottle of 120 tablets
1-5 bottles $11.00/bottle
6-11 bottles $10.00 bottle
12+ bottles $9.00/bottle
   
ATP COFACTORS
Bottle of 90 tablets
  $18.00/bottle
   
   
ANDROVITE® FOR MEN
Bottle of 180 tablets
1-5 bottles $18.00/bottle
6-11 bottles $16.50/bottle
12+ bottles $15.00/bottle
   
[ ] UPS [ ] UPS Next Day* [ ] UPS 3-Day*
[ ] USPS Mail** [ ] UPS 2nd-Day* [ ] COD $11.00
     
*Available for extra cost
**For PO boxes only
CA residents add
9% sales tax
 

COD

 
Shipping $6.00
TOTAL  
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