Fax Order Form - Magnetic Therapy Sales Specialists, Inc.

Magnetic Therapy Sales Specialists, Inc. FAX ORDER FORM - PRINT THIS FORM AND FAX TO: (239) 936-4818 Please include phone and Email contact information so we can confirm your total with shipping before processing your order.
Name
Address 1
Address 2
City, State, Zip
Country
Daytime Phone:
Email Address
Item #	Item Name & Size (if applicable)	Price



Credit Card #
Expiration
Name on Card (if different from above)
Card Billing Address w/ zip (if different from above)
Thank You! We will confirm order total including shipping. Please save this form for your records. Magnetic Therapy Sales Specialists, Inc. 1860 Boyscout Drive #209 Fort Myers, FL 33907 Order Line: 1-888-883-0813 Fax Line: 1-239-936-4818