Print this sheet for your order and mail. This is 3 pages long.
If you want a 1 page long order form, click here.
NO PRINTER? If you do not have a printer, carefully write out your order with your name, mailing address and a contact phone number in case we are not certain what you are ordering.
Celeste's HCG Mail-In Order Sheet
    We will send your order by U.S. Post Office FAST PRIORITY MAIL for FREE and email you the tracking number.  Fill-in your order and mail our order. We will rush your order to you by Priority Mail.
Free USPS Priority Mail. HCG & B-12 Complex in Amber Glass Dropper Bottles
# Product List Price Sub-Total
Sublingual HCG    
  1 Ounce HCG in 1 ounce glass dropper bottle $33.88 _______
2 Ounce2 HCG in 2 ounce glass dropper bottle $45.38 _______
  4 Ounces HCG in two 2 ounce glass dropper bottles $60.73 _______
6 Ounces HCG in three 2 ounce glass dropper bottles $81.31 _______
  Add B-12 Complex To HCG Order    
  1 Ounce HCG + 1 Ounce B12 in 1 ounce glass dropper bottles $43.51 _______
  2 Ounces HCG + 2 Ounces B12 in 2 ounce glass dropper bottles $61.11 _______
  4 Ounces HCG + 4 Ounces B12 in 2 ounce glass dropper bottles $87.96 _______
  6 Ounces HCG + 6 Ounces B12 in 2 ounce glass dropper bottles $109.82 _______
  H.G.H. Human growth - single chain amino acid monomer   _______
  30 Day Supply H.G.H, 2 per day. 60 caps $18.43 _______
  60 Day Supply H.G.H, 2 per day. 60 caps $26.43 _______
  90 Day Supply H.G.H, 2 per day. 60 caps $35.43 _______
  Celeste's TOTAL HCG KITS
Maximum fast weight loss - BEST savings
   
  15 Day HCG Kit
The Regular Price JUST for HCG is $89 - so you SAVE
$66.72 with 25% discount (total savings over $50 with bonuses)
$66.72
______
  30 Day Weight Loss HCG Kit
The Regular price JUST for the HCG  is $149.00-with 25% discount
$97.75 with 25% off PLUS $20.00 discount (total savings over $120 with bonuses!)
$97.75
______
  45 Day Weight Loss HCG Kit
Regular Price JUST for HCG - $199.00

$147.21 with 25% discount (you save over $100 with free bonuses)
$137.21
______
  60 Day HCG Weight Loss Kit
Regular Price JUST for HCG $249.00
$173.72 with additional 25% discount
(you save over over $250 with free bonuses!)
$153.72
______
  90 Day HCG Weight Loss Kit
90 days: (If you are SERIOUSLY NEEDING to Loss weight or for weight maintenance inventory) $173.72

You save $349+!
and with additional 25% discount
$173.72

______
  Celeste's
Mega Weight Loss Vitamin & Mineral Supplement

(available ONLY with an order of an HCG program above)
   
  Celeste's Mega Weight Loss Nutritional Support:
For your 15 day program -Retail $18.38

Sale: $9.73 with no additional shipping charge
(you save over 50%)
$9.73
______
  Celeste's Mega Weight Loss Nutritional Support:
For your 30 day program - Retail $32.47
Sale: $15.73 with no additional shipping charge
(you save over 50%)
  $15.73
______
  Celeste's Mega Weight Loss Nutritional Support:
For you 45 day program   Retail $48.21
Sale: $17.31 with no additional shipping
(you save over 50%)
$17.31
______
  Celeste's Mega Weight Loss Nutritional Support:
For your 60 day program
(THIS IS FREE with the 60 day program)
  Free with
60 day kit
  Celeste' Mega Weight Loss Nutritional Support:
For your 90 day program
(THIS IS FREE with the 90 day program)
  Free with
90 day kit
  Celeste's sublingual B-12 Complex
Calms while keeping energy level up
   
  I ounce - enough for 16 days: Retail $18.38
Sale: $9.73 with no additional shipping charge (you save over 50%)
$9.73 ______
  2 ounces - enough for 32 days: Retail $32.47
Sale: $15.73 with no additional shipping charge (you save over 50%)
$15.73 ______
  3 ounces - enough for 48 days:Retail $48.21
Sale: $17.31 with no additional shipping (you save over 50%)
$17.31 ______
  4 ounces - enough for 64 days
(This is included FREE in you 60 day program)
  Free with
60 day kit
  6 ounces - enough for 96 days
(This is included FREE in your 90 day program)
  Free with
90 day kit
  Celeste's H.G.H.    
  Celeste's H.G.H. 60 Capsules (30 day supply)
 
Retail:
$43.95  Sale: $17.43
(You Save $26.52)
$17.43
______
  Double it for just $9
Celeste's
H.G.H. 120 Capsules
(60 day supply)
Retail:
$74.95   Sale: $26.43
(You Save $46.52)
Sale: $26.43 + Free S&H
$26.43
______
  Double it AGAIN for just $9
Celeste's
H.G.H. 180 Capsules
(90 day supply)
Retail:
$119.95    Sale: $35.43
(You Save $84.52)
$35.43
______
  FREE BONUS WITH HCG ORDER
30-Day Supply of the Skinny Pill 5 in 1
 Free with HCG Order ______
 
IF YOU ARE ORDERING A FULL KIT?
(CelestePureH2O2.Com)
 
 
TOTAL:
$____________
(Free US Post Office Priority Mail shipping)                            

Date: ________________________

  Name: ______________________________________________

  Address: _______________________________________________________________

  Apt/Unit/Suite #__________________

  City: _________________________________________ State _______ Zip __________

  Contact Phone Number: _________________________________

   Email Address to send tracking number: _________________________________


  Special Instructions if any: _________________________________________________


_____________________________________________________________________
                                       (Use back of page for additional instructions)


  I verify that I am at least age 18: ________________________________
                                                           Signature or Initials

OPTIONAL (You Do NOT have to answer these)
We NEVER release anyones information to anyone.

  Age: ___________   Gender M/F: ______________ Weight Loss Goal: __________lbs
 
MAIL YOUR ORDER WITH A MONEY ORDER PAYABLE TO:
"Pure Health"

Mail To:
Pure Health
Attn: Celeste
P.O. Box 636
Crystal River, Florida 34429