In addition to placing your order online from your own home computer, we offer this printable order form for your convenience. Please be sure to fill in all applicable information and print legibly. We will not share your personal or credit card information with anyone (see our privacy policy). Your phone number and/or e-mail address is requested in the event that we need to contact you concerning the processing of your order. Orders can also be placed via e-mail or over the telephone. Important note: Any orders being shipped to a PO Box or military address must use USPS Priority Mail for your shipping option. UPS does not deliver to PO Boxes as it is a different carrier. If you need more room to add more products, please add them on the back of this form.
P.O. Box 1025 • Langhorne, PA 19047 • Ph: (866) 437-3122 • Fax: (866) 437-3124
E-mail: customerservice@viable-herbal.com • Business Hours: 8:00 am to 5:00 pm (EST)
Billing Information: Shipping Information:
Name on Card:   Name:  
Complete
Address
(where
credit card
bill is sent):

 

 

 

 Complete
Address:		  
Phone #:   E-mail:  
Card Type:
(circle one)
Visa       Mastercard       Discover       American Express
Expiration Date:
 
Card #:
 
*3- or 4-Digit
Card Code:
 
Signature:
   * Visa, Mastercard, and Discover have a 3-digit number on the back of the card, and American Express has a 4-digit number on the front for security purposes.
Check or
Money Orders:
Please make your check or money order payable to Viable Herbal Solutions and mail it along with the completed order form to the address above. We accept U.S. funds only.
Item #
Item Description
Quantity
Unit Price
Total Cost
         
         
         
         

Customer Comments:

 

Shipping Method:
(Fill in the box next to your desired method and calculate on right)
Subtotal:
  
 Standard Shipping: USPS Priority Mail ($4.75)
 UPS 3-Day: US ONLY ($12.50)
Shipping Charges:
(see chart at left)
 $
 UPS Second Day Air: US ONLY ($20.00)
 UPS Overnight: US ONLY ($30.00)
 UPS Saturday Delivery: US ONLY
(Add $10.00 to the price of the method you choose above)
Final Order Total:
$
International: USPS Global Express
($30.00 - delivery time 3-5 business days)
International: USPS Priority Mail International
($22.50 - delivery time 6-10 business days)
Thank you for doing business with Viable Herbal Solutions!