MedsMex.com: Order Form for Quality Discount Prescription Medicines.

Printable Order Form To order from MedsMex.com, just print and complete this form and mail it to: MedsMex.com, c/o Today's Business 6510 South Sixth Street #38, Klamath Falls, OR 97603, USA (Today's Business provides secretarial services to Medicine-Mexico.) Please allow 10 to 21 business days for delivery of your order. All prices shown on our product list are in U.S. dollars. For a currency converter, click here.
Medicine Name	Dosage (gr, mg, mcg)	Price	Quantity	Total per Item






Subtotal:				USD$
Shipping and Handling:				USD$ 10.00
Total cost: Your items plus shipping costs. (Allow 10 to 21 business days for delivery.)				USD$
PLEASE NOTE: Because all orders are shipped via registered mail from Mexico, we cannot process rush orders.

Please make your Check or Money Order payable to
Today's Business.

How did you hear about MedsMex.com? (From eBay, classified ads, newspaper, friend? If by search engine, which one?)

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Your Name:
Street:		City:
State:		Postal Code:
Country:	Email Address:
Daytime Area Code and Phone:

FOR CREDIT CARD PAYMENT PLEASE FILL THE FOLLOWING INFORMATION

Cardholder name:

Type: MasterCard VISA AMERICAN EXPRESS

Credit Card Number:
CCV(For American Express Only)

_______

Expiration Date: Month______ Year ______

FOR CREDIT CARD PAYMENT PLEASE FILL THE FOLLOWING INFORMATION
Cardholder name:
Type:	MasterCard	VISA	AMERICAN EXPRESS
Credit Card Number:			CCV(For American Express Only) _______
Expiration Date:	Month______ Year ______