Check the boxes next to the
items you wish to purchase. You will have a chance
to preview your order summary before it is finally
processed.
Item
Description
Price
Qty
Mor-Loc Cervical Support
Neck Support
$
40.00
Tri Core Neck Support
Pillow
Standard Size Pillow
$
40.00
Mor-Loc Lumbar Support
Low back support
size
$
40.00
Mor-Loc Cervical Support
Neck Support - One Size
Fits All
$
40.00
Shipping and Billing Information
2.
Bill my
credit card for these
purchases.
If you do not wish to make
payment by credit card, then leave the card
information blank and check the box to pay by
check or money order. Otherwise, complete the card
information to pay by credit card.
Expiration Date
Card Number
/
Card Holder
3.
I'll send a check or money
order for payment.
If paying by check or money
order, check the box above. You'll be able to
print a final invoice for mailing or faxing.
4.
What is the shipping destination
?
Your Chiropractic Health
Centre purchases will be sent to the following
person and location.
Name
State
Address
Postal Code
City
Country
5.
Additional customer information.
Please enter your customer
information, including phone number and email
address in case we need to clarify your order
information. If the same as shipping destination,
then just fill in Phone and Email.
Name
Address
City
State
Country
Postal Code
Phone
Fax
Email
6.
Special instructions and
additional information.
Please enter any special
instructions or additional information about your
order.
7.
Proceed to the next screen to
Select Quantities.
When you click the "Select
Quantities" button your chosen items will be
listed and you can select quantities of each item
if you want. Nothing is processed or billed until
you preview your invoice. The buttons on this page
do not process any billing. And, thanks for
shopping at Chiropractic Health Centre.
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