Order Form

DERMAZINC SECURE ORDER FORM
Our Products Are Sold By Mail Order

To order DermaZinc by phone call our
customer service toll free (U.S.) at:

1-888-700-VITA(8482)
(From outside the U.S. call 213-380-0717)

OR
fill out the Form below

       (Add S&H)
(California residents add 8.25% tax)

 

DermaZinc
Pump
Spray
(How many?)

DermaZinc
Shampoo

     

DermaZinc
Soap
(How many?) (How many?)

DermaZinc
Cream
4 oz


(How many?)


PRESCRIPTION STRENGTH
DERMAZINC-PLUS
Dermazinc Spray 4oz
&
Clobetasol Propionate
(0.05%)
01 - $44.95 Each
02 - $41.35 Each
03 - $40.01 Each
04 - $37.31 Each




How
many?

Dermazinc Cream (4oz)
AND
Clobetasol Propionate (0.05%)
$33.45


Dermazinc Shampoo (8oz)
AND
Clobetasol Propionate (0.05%)
$29.95



How
many?



How
many?

Click here to print the Prescription
Form for Dermazinc-Plus
 		 


If you live outside of the United States click here .

We ship all our products World Wide and the Shipping costs will depend
on the weight of your package. If you would like to know the costs before
we mail it to you, fill and submit the form below only with your name, 
complete address, Email and the number of units you would like to buy.
After you submit the Form, send us an Email: Contact@Sanavita.com

(Orders outside USA payable by Credit Card or Money Order in U.S. Dollars only!)


Personal Details:

Diagnosis :  
Name :  
Street Address :
City:                  State:   Zip:
Country:             
Day Phone:       
Home Phone:     
Email:               


Methods Of Payment :

  Credit Card :
Mastercard
Visa
Credit Card Number :                  
Exp. date:                Month  Year
 Check By Mail or
 Money Order :		 Mail check or Money order payable to Sanavita Enterprises
3932 Wilshire Blvd. Suite 304             
Los Angeles CA 90010


 

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 E-Mail us at sanavita@mail.serve.com



Copyrights and Design by Rod Trindade
Email Rod Trindade@sanavita.com
Last Updated: November 2000