Please make your Check or Money Order payable to Long Life, Inc.

Please use your printer to make a copy of this order form. 

Please Print or Type.

Send your Check/Money Order to the address below. 

For Credit Card orders, please call Toll Free 800-560-4889

 
Toll Free 800-560-4889         Mail To: Snore M.D.
Fax: 561-658-8124 a Long Life Company
16000 Ventura Blvd., Suite 1105
Encino, CA  91436
USA 
Shipping Information: (Please Print or Type)
Name:
Address:                                                          Apt.#
City: State/Province:                 Zip/Postal Code:
Country: E-Mail Address:
Work Phone: Home Phone:
Payment Information:
Check ______  Money Order ______  Credit Card _________
Visa ______ MasterCard _____ Amex ______ Discover ________
Credit Card#_______________________    EXP:__________  (mm / yy)
ORDER FORM
Prod. Code  Description Quantity Price Total
1SMD Snore M.D. 60 caplets bottle   $29.95  
3SMD Snore M.D. 60 caplets bottle (2"+1"Free) (save: $29.95)   $59.90  
1TSMD Snore M.D. 3 Travel Size Packs (3 caplets each)  S/H 4.95   FREE  
1DSMD 12 Bottles of Snore M.D. (S/H - FREE)   $210.00  
HV Herbal V 30 caplets bottle   $19.95  
LV Lady V 30 caplets bottle   $19.95  
1AL60 Allergy M.D. 60 caplets bottle   $19.95  
3AL60 3 Allergy M.D. 60 caplets bottle includes 3 Travel Size Packs of Snore M.D.   $49.95  
1MMD Memory  M.D.  60 caplets bottle NEW ITEM   $24.95  
 

ADD SHIPPING ($6.95 USA or $9.99 Canada)

      
Form 304/01

Total:

      

Thank you for your order!

 * International Shipping Rates: - please write for a quote sales@snoremd.com
How long does it take to receive my order?
  • Usually it will arrive within 3 days. All orders in the Continental U.S. are shipped via Priority Mail. Outside the U.S. orders are shipped U.S. Air Mail and should be received within 4 to 10 days.
For More Information Contact: 
Long Life, Inc.
Tel: 800-560-4889     FAX: 561-658-8124 
e mail info@snoremd.com