hypnosisMD - custom made order form

hypnosisMD
custom made order form
30 day money back guarantee. Shipped discreet & tamper evident.

Your order can be submitted in 2 ways:
1. Online here. 2. Print and mail or fax it.

Enter the name of illness/condition and we will create recording(s) to treat it

All 4 CDs (clearing, hypnosis, subliminal and sleep) recommended $298
and/or
single selections $98 each
clearing hypnotic subliminal sleep

SELECT SHIPPING
shipped in 1 week $20
shipped in 2 weeks $10
shipped in 3 weeks $5
shipped to outside USA $20 in 1 week via Air Mail

$ Insurance (complete delivery coverage) add $5
$ Shipping/Handling (per order)
$ GRAND TOTAL

Your name & Address (please TYPE or PRINT clearly)

Evening Phone:

Day Phone:

E-mail:

Where did you hear about us?

SELECT:
check/money order (enclosed)
MasterCard Visa AmEx Discover
credit card # expires: (mm/yy)

MAIL, EMAIL, OR FAX YOUR ORDER
No COD. USD($) only, payable to hypnosisMD (thank you)

Mail to: hypnosisMD
786 Bush Street #16
San Francisco, CA 94108 USA
Email: jhs@hypnosismd.com
FAX: 415-399-9240

home