SUPPLEMENT ORDER FORM
 
NAME 
Ship to ADDRESS - Where you want product shipped. No PO BOXES PLEASE
STREET CITY  STATE  ZIP 
Bill to ADDRESS - should be same as address used for credit card
STREET CITY  STATE  ZIP 
E-MAIL 
PHONE (home)   (work) 
 
PAYMENT INFORMATION:
          Existing clients: Please charge my credit card that you already have on file
          I am a new customer. I will fax my order and provide you with my credit card number.
 
CREDIT CARD INFORMATION:
 

Select One

Card Number Exp Date Code

VISA
Master Card
Discover
American Express
COMMENTS or special instructions:
 
 
Please check items below that you want to order

Kantita & Foon Goos #2

Candida Cleanse
  Kantita 12.00
  Foon Goos #2 12.00
  Olive Leaf 15.00
  Oregano Oil 25.00
  Taurin-Dophilus 9.00

 

Female Balance

Female Problems / unusual Pap results/ Fibroids / Cysts / Urinary Tract
  Female Balance 9.00

  Female Tea 6.00

  PAP 12.00

  Chaste Berry 14.00

  Cranberry 13.00

  Okra Vites 11.00

 

Hormone Balance

Hormone Balance
  Women's' Gold 10.00
  Olive Leaf 15.00
  Rosemary Plus 11.00
  Black Cohosh 17.00
  Cyst Ease 13.00

Artery Cleanse

Artery Cleanse
  Circuflo -30 day cleanse 32.00
  Aloe Vera Gel 13.00
  Booklet of Testimonials free

 

Parasite Cleanse

Parasite Cleanse
  Parasite Book 8.00
  5 Bottle package Kroeger Parasite Cleanse * 50.00


*
Wormwood, Rascal, Black Walnut tincture, Cloves and Garlic

 

 

Men's Health

Men's Health
  Men's Special 11.00
  Saw Palmetto Tincture 13.00

 

 

Multivitamins

Multivitamins by Super Nutrition
  Perfect Blend 240 caps 56.00
  Women's Blend 90 caps 27.00
  Perfect Kids 100 caps 14.00

 

 

Blood Sugar Balance

Blood Sugar Balance
  Glucobetic 24.00
  Pancreas Tonic 42.00
  Chromium GTF 5.00
  Chromate 27.00
  Glucofactors 20.00

 

Greens

Greens Products
  Greens Plus 360 caps 38 .00
  Greenergy 180 caps 47.00

 

 

Liver Gallbladder Cleanse

Liver / Gall Bladder Cleanse
  Liver Rinse 17.00
  Milk Thistle 20.00
  Liver/gallbladder Remedy (Tincture) 16.00

 

 

 

Colon Cleanse

Colon Health Cleanse
  Colonic Rinse Capsules 22.00
  Aloe 225 capsules 17.00
  Aloe 450 tablets 15.00

 

Colon Health Products
  Colon Max 60 veggie capsules 20.00
  Acidophilus 250 capsules 13.00
  Meta Fiber Powder 24.00
  Herbulk Powder 18.00
  FiberMax (Flax Fiber) 26.00
  Psyllium Husk capsules 8.00

 

Natural Thyroid Products
  Thyroid Tissue 90 tablets 26.00
  Liquid Iodine Tincture 13.00
  Thyroicare (recommended by Dr. Wilson) 75 veggie capsules 26.00
 

Total Charged to card $ _____________

 

Signature _________________________________

 

 

Ventura Center for Healing
19525 Ventura Blvd., Tarzana, CA  91356
Phone (818) 343-3571
www.venturacenter.com