Health Home Test
To Order Online simply select the product or products from the Online Catalog, type the quantity ordered into the order window and click the Add to Cart button.
To Order by Mail simply fill in the appropriate blanks in the form below, then print the form with the print funtion of your web browser. All fields are required. Mail the form to:
Health Home Test, LLC - Attn:Customer Service - 2600 Cole Avenue, Suite 132 - Dallas, TX 75204
To Order by Phone call toll-free 1-877-275-7613
Quantity discounts are available on telephone, fax and mail orders only.
 
Fax & Mail-in Order Form
Name
Shipping Address
City State Zip
Please supply a street address if you choose UPS or FedEX as your shipper.
Billing Address
City State Zip
Your billing address must match the address on your credit card.
Phone
Email address
Payment type
Checks must be drawn on a US bank in US dollars.
Credit card number
Credit card expiration date
Products
QUANTITY PRODUCT NAME UNIT PRICE TOTAL PRICE
SHIPPING:
SALES TAX: Texas only 8.25%
TOTAL:

Use the print function of your browser to print this form.

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