Order Form
REMEMBER to order extra filters to keep your
condition for many years of happy, healthy breathing! Try a different aromatherapy essential oil and order an
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(12 pack) |
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Mouthpiece Covers
(2 pack)
(10 ML bottle) | ||
Bee Happy | ||
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Rear Cabinet Filter
Air Intake Filter
Side Cabinet Filter
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| (10 ML bottle) |
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| Bee Calm |
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CUT ✁ |
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| CUSTOMER INFORMATION (please print) |
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| NOTE: No delivery to P.O. Boxes | |||
| Name | M.I. Last Name |
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| or APO addresses. |
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Complete Street Address |
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| Apt. / Suite # |
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City |
| State | ZIP Code | Daytime Phone Number |
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ORDER INFORMATION |
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Item # | Item | Quantity | Regular Price | Promo Code | Total |
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| $ | 699.00 each | _____________ | $ ____________ | |||
Headset (includes 12 filters, 2 mouthpiece covers) | $ | 39.95 each |
| $ ____________ | |||
Headset Hose (6.5 feet) |
| $ | 14.95 each |
| $ ____________ | ||
Mouthpiece Filters (12 pack) |
| $ | 12.95 each |
| $ ____________ | ||
Air Intake Filter |
| $ | 12.95 each |
| $ ____________ | ||
Mouthpiece Covers (2 pack) |
| $ | 14.95 each |
| $ ____________ | ||
Rear Cabinet Filter |
| $ | 11.95 each |
| $ ____________ | ||
Side Cabinet Filter |
| $ | 11.95 each |
| $ ____________ | ||
Set of Relaxation CDs (6) |
| $ | 60.00 each set | $ 29.95 each set | $ ____________ | ||
Aromatherapy (10 ML bottle) | Bee Happy | $ | 18.00 each |
| $ ____________ | ||
Aromatherapy (10 ML bottle) | Bee Calm | $ | 18.00 each |
| $ ____________ |
SHIPPING & HANDLING
Shipping & Handling for the
For all shipments of any product outside the Continental United States, call for shipping rates.
Please Make Check or Money Order payable to: O2 Innovations™
METHOD OF PAYMENT: DO NOT SEND CASH
For all other items include $ | 4.95 S/H EACH $_____________ |
PA Residents include 6% Sales Tax | $_____________ |
Total Amount Due | $___________ |
Allow 2-6 weeks for delivery
Check | Money Order VISA | Mastercard American Express | Discover | (This is the 3 or 4 digit code on the front |
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Credit Card #: ______________________________________________________________________ CVM#:_______________ or back or your credit card)
8/2005
Card Holder’s Signature: ______________________________________________Name as it appears on card: ______________________________________________ (Please Print) | 14 | |
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Fax order to: | Oxygen Is Beautiful™ | |
You may also order at |