Fax/Mail Order Form  

Mail to: Fax to: Help / Questions:
2430 Torrance Blvd, Suite. A
Torrance, CA
90501, USA
 1-408-273-6490 support@herbsmd.com
PID SKU Manufacturer Product Name Qty Price Total
             
             
             
             
Sub Total  
Shipping Charges*  
Tax * *  
Total Amount  

 


 ** Tax is applicable on all orders shipping to CA addresses. Please add 8.25% Tax of order amount.

Shipping Rates
You can choose from a variety of shipping options. For orders worth $89.99 or less, shipping charges are applicable based on following shipping rate matrix.

  Normal Orders Overweight Orders
$89.99 or less Over $89.99 $89.99 or less Over $89.99
Ground $6.00 FREE Calculated* Reduced **
3-Day Calculated* Calculated*
2-Day Calculated* Calculated*
 

* Calculated using rate list provided by our logistics partner based on your order weight and shipping address.
** For overweight orders worth $90 and above, calculated shipping charges will be reduced significantly and applied to your overweight order.
   
Shipping Address
Name  
Company Address  
Mailing Address  
City  
State  
Zip Code  
Country  
Billing Address
(If different from Shipping Information)
Name  
Company Address  
Mailing Address  
City  
State  
Zip Code  
Country  

Shipping Method
  UPS - Ground_____   UPS - 2nd Day Air_____   UPS - 3 Day Select_____

Payment Method
VISA Card _____ Master Card_____ Amax Card_____ Discover Card_____  
 
Name on Card__________________________
Credit Card Number_____________________

Expiration Date (MM/YY)______ / ________
Signature of the Cardholder______________

E-mail______________

 

FAX THIS ORDER FORM TO 1-408-273-6490
After receiving your Fax we will send you a conformation e-mail. Thank You!