Equipment Order Form


EQUIPMENT ORDER FORM

S.Calif. OFFICE: 909-338-3533 / ORDER FAXLINE: 909-338-3743
FAXLINE AVAILABLE 24 HRS./DAY (shares DSL modem so be patient if it is busy)

PRICES ARE SUBJECT TO CHANGE. ORDERS ARE PROCESSED ON CURRENT WEBSITE LIST PRICE WHEN ORDER IS PLACED.
PLEASE BE SURE TO FILL OUT INFORMATION BELOW COMPLETELY SO WE CAN COMPLETE YOUR ORDER IN A TIMELY MANNER. THANK YOU.

(Please Type in ALL CAPS)
SHIP TO ADDRESS (UPS /Fedex Will Not Deliver To Post Office Boxes)
NAME TELEPHONE:
STREET
CITYSTATE ZIP
EMAIL:Confirm Email
Best Time to Reach You With Questions

MAILING or BILLING ADDRESS (If different than Shipping Address)

NAME: TELEPHONE:
P.O.BOX / STREET
CITY:STATE: ZIP:


ITEM DESCRIPTION

X

# UNITS

PRICE

TOTAL

BIOSPECTRA™
LIVING SPECTRA 3 PIECE
OZONE COMPATIBLE FAR INFRARED SAUNAS
BioSpectra FIR Ozone Compatible Sauna System

N/A

Click link below to order saunas
Sauna Order Form

N/A

OZONE & OXYGEN EQUIPMENT

X

# UNITS

PRICE

TOTAL

AHW100 DELUXE OXYGEN-FED OZONE GENERATOR W/10-STEP FREQUENCY SWITCH FOR MAX.FLEXIBILIT IN OUTPUTS
(NOTE: OXYGEN TANKS OR CONCENTRATORS ARE PURCHASED SEPARATELY)
AHW100 Ozone Generator

$1295.00

AHW300 OXYGEN or AIR FED OZONE GENERATOR
AHW300OzoneGenerator

$249.95 (Includes 250ml Resuable Air Dryer)

500 ml Air Dryer $27.00

OZONE OIL & WATER BUBBLERS
EUROPEAN HAND BLOWN COBALT BLUE GLASS BOTTLES & STANDS W/ SILICONE TUBING & KYNAR LUER LOCK ADAPTERS
SINGLE, DOUBLE, TRIPLE W/METAL STANDS
OZONE EQUIP, ACCESSORIES & RELATED PRODUCTS

Single Round Blttle $18.00

Single Rd.Bottle w/stand $21.00

Single Sq.Bottle Kit $18.50

Double Rd.Bottle Kit $36.00

Double Sq.Bottle Kit $37.00

Triple Stand w/Rd.Bottles Kit $60.00

Triple Stand w/Sq.Bottle Kit $62.00

0 - 4 LPM VERY LOW FLOW CGA540 THREAD STYLE OXYGEN REGULATOR
(1/32nd / 1/16th / 1/8th / 1/4th / 1/2 / 3/4 / 1 / 1.5/ 2.0/ 2.5 /3.0 j/ 3.5 / 4.0)

$115.00

  HIGH VOLUME AROMATHERAPY NEBULIZER Atmospheric Ozone Deactivator
Includes Air Pump, Blue Neb. Bottle, Adapter, Hand Blown Belgium Glass Tulip Bulb, Stand, 4 oz. Custom AAA Grade Essential Oil Blend
Makes beneficial ozonides

$159.00

  OXYGEN NEBULIZER
Screw on 2 oz. reservoir for medications, water, etc. 8 ft.Oxygen Tubing. Extensions Avail.

$15.00

  OZONE BUBBLER KIT
Includes: 16 oz. glass bottle w/silicone stopper, stainless steel support, silicone tubing, ceramic fine bubble diffuser, kynar 1/8"id leur lock connector; 8 oz. French Dark Cobalt Blue Oil Bubbler (protects oil from uv light) with silicone stopper, stainless steel support, silicone tubiing, ceramic non-clog oil diffuser

$39.95

E.W.O.T. SYSTEM HOME KIT
EWOT (Exercize with Oxygen Therapy) Kit Includes: (1) Very Low Flow CGA540 0-4 LPM Oxygen Regulator; (2) Nasal Canulas (1) Oxygen Humidifier Bubbler (1) 8 oz. Liquid Nano-Germanium
Instructions EWOT info.

$199..00

MISCELLANEOUS

X

# UNITS

PRICE

TOTAL

BLUE RADIANCE
FACIAL ANTIAGING MICROCURRENT
w/BLUE LED DEVICE
blueradiance info.

$495.00 ea.
Shipped directly from Manufacturer Warehouse via UPS Ground. Please allow 12-14 business days.

LYMPHSTAR PRO HARMONIC PLASMA FIELD FREQUENCY LYMPHATIC THERAPY DEVICE lymphpro device info.

$4000 + S & H
2 Standard Heads. (Note: Shipped directly from Manufacturer'sWarehouse via UPS Ground. Please allow 12-14 business days.)
FULL INTERNATIONAL POWER CAPABILITY
ADDITIONAL HEADS (UP TO 4) CAN BE ADDED
Upgraded Generator, New Pullse Rate Dial with Sweep Function
Removable power cord

LYMPHSTAR PRO FUSION MULTI-PHOTONIC HARMONIC & PHOTO THERAPY MODULAR SYSTEM
Lymphstar Fusion Therapy Device

$5600.00 + S & H
Basic Model Includes:
2 Standard Treatment Heads + 1 LED Photo Head

LYMPHSTAR LITE-HOME MULTI-PHOTONIC HARMONIC & PHOTO THERAPY LYMPHATIC DRAINAGE & AETHETICS DEVICE
LymphstarLite

$3200.00 + S & H
(Note: Shipped directly from manufacturer's warehouse via UPS Ground. Please allow 12-14 business days)
Includes 2 Standard Treatment Heads
Non-Upgradeable
Hard wired power cord

PEACEMAKER
SCHUMAN RESONANCE EMITTER
Protects from Harmful Chatoic Energies & EMFs (Up to 100 ft. Radius)
Schuman Resonance Products

Shipped directly from US Manufacturer'sWarehouse Unless Otherwise Requested. Domestic Shipments, Please allow 12-14 business days. Int'l. Shipments Take Longer.
We use US GXG Mail (guaranteed Express) for Int'l.

ITEM SUBTOTAL

(Only Calif. Residents Pay 8.75%) CA SALES TAX

CHOOSE SHIP METHOD :

SHIPPING RATES:

HANDLING: 3% ON ORDERS LESS THAN $450.00
(take 3% of Item Subtotal )

TOTAL DUE
STOP !! PLEASE READ !! ------
We do NOT process orders directly over the Internet (No Shopping Cart System) intentionally to insure we speak with
interested parties to determine if the products are appropriate or not since we have a no refund policy.

ORDERING POLICIES & INSTRUCTIONS
TO PLACE YOUR ORDER, PLEASE FILL OUT THE FORM ONLINE
Print off this form at 80% and FAX IT IN -- or --
Hit "Print" and then select "Save As PDF" to desktop. Email us and attach the PDF order form.
Thank You.
FAX (909)338-3743 / (909)338-3533 Office & VM

We accept phone orders 9-5 PST M-F, Sat. 10-2. If the line is busy, PLEASE leave a message and we'll do our best to call back.
We're a private healthcare practice and sometimes we get behind in callbacks. Please be patient. Call again if its been more than 2 days.

Any order valued over $150 requires a written order for. It can be called in but will not be
processed without written and signed order.
PLEASE READ & ACKNOWLEDGE BELOW

PURCHASE TERMS & POLICIES

REFUND / EXCHANGE POLICY :
Generally all sales are final with the exception of the Ozone Oil & Water Bubbler which we make ourselves and we will refund or replace any damaged units. No Returns or Refunds. Exchange only for Factory Defects within 30 days.

WARRANTIES: Warranties are Manufacturers Only and subject to their terms and conditions. Requests for Refund or Exchanges must be received in writing by our office within 10 days of the receipt. We will call to discuss the request and give if deemed appropriate give an authorization # which needs to be written on the left hand corner of the box above the label. Customer bears all return shipping expense unless there is a valid product manufacturers defect which will be determined by our engineers or technicians. Refunds are solely at our discretion after we determine cause. No Returns for Exchange without written request and authorization.

SHIPPING /FULFILLMENT: Orders which have current stock will be processed within 4-7 business days unless there is a backorder on a particular item in which case the customer is notified when placing the order. All orders are prepaid in advance. Please allow 12-14 business days for receipt. Backorders will be shipped as soon as available by invoice date, oldest first. If for some reason there is an undue delay in receipt of stock from a vendor, we will notify the customer and issue a credit for the item which was backordered or exchange it for another product of same or lesser value at the customer's discretion.
PLEASE CHECK & SIGN BELOW ( required for processing ALL orders )

I have read and understand the terms of this order and agree to purchase terms. Signature

PLEASE READ & ACKNOWLEDGE BELOW

**PURCHASE TERMS & POLICIES**
REFUND / EXCHANGE POLICY : Generally all sales are final with the exception of the Ozone Oil & Water Bubbler which we make ourselves and we will refund or replace any damaged units. No Returns or Refunds. Exchange only for Factory Defects within 30 days. WARRANTIES: Warranties are Manufacturers Only and subject to their terms and conditions. Requests for Refund or Exchanges must be received in writing by our office within 10 days of the receipt. We will call to discuss the request and give if deemed appropriate give an authorization # which needs to be written on the left hand corner of the box above the label. Customer bears all return shipping expense unless there is a valid product manufacturers defect which will be determined by our engineers or technicians. Refunds are solely at our discretion after we determine cause. No Returns for Exchange without written request and authorization. SHIPPING /FULFILLMENT: Orders which have current stock will be processed within 4-7 business days unless there is a backorder on a particular item in which case the customer is notified when placing the order. All orders are prepaid in advance. Please allow 12-14 business days for receipt. Backorders will be shipped as soon as available by invoice date, oldest first. If for some reason there is an undue delay in receipt of stock from a vendor, we will notify the customer and issue a credit for the item which was backordered or exchange it for another product of same or lesser value at the customer's discretion.

PAYMENT INFO.

PLEASE TYPE INFO. IN ALL CAPITAL LETTERS FOR EASIER LEGIBILITY

PLEASE CHOOSE PAYMENT METHOD BY CHECKING A BOX

CREDIT CARD #
EXPIRATION DATE: MONTH YEAR
3-DIGIT SECURITY V.I.D.NUMBER (back of card on far right ***)

NAME AS ON CARD:

E-MAIL ADDRESS FOR SHIPPING & TRACKING INFO

AUTH. SIGNATURE

Credit Card Billing Address is the same as above billing address
Credit Card Billing Address is different from that shown above.(fill out below)
Address:CityState
ZipCode Telephone



ORDER FAXLINE (909) 338-3743
TELEPHONE ORDERS (909) 338-3533
P.O.Box 3668 * Crestline, CA 92325
E-mail: drcnb@js-net.com *www.arrowheadhealthworks.com
ContactWebmaster for site info.or problems at drcnb@js-net.com


ITEM SUBTOTAL
(Only Calif. Residents Pay 8.75%) CA SALES TAX

CHOOSE SHIP METHOD :

SHIPPING RATES:
HANDLING: 3% ON ORDERS LESS THAN $450.00 (take 3% of Item Subtotal )

TOTAL DUE

PLEASE CHOOSE PAYMENT METHOD BY CHECKING A BOX
CREDIT CARD # EXPIRATION DATE: MONTH YEAR 3-DIGIT SECURITY V.I.D.NUMBER (back of card on far right ***)
NAME AS ON CARD:	E-MAIL ADDRESS FOR SHIPPING & TRACKING INFO
AUTH. SIGNATURE
Credit Card Billing Address is the same as above billing address Credit Card Billing Address is different from that shown above.(fill out below) Address:CityState ZipCode Telephone