HCGSupplies.com, LLC Mail-In Order Form
 You can type your order in this form; then print and mail this form, along with payment, to:
 HCGSupplies.com, LLC
P.O. Box 1783
Dahlgren, VA  22448
(Or you can print out the form and then write in the boxes by hand.)

Make Your Cashier's Check Or USPS Money Order payable in US Dollars to: HCGSupplies.com, LLC

You may also print this form and fax it to us at:
1-520-844-9303

Please email us with any questions or concerns before sending payment.

REMEMBER - ALL orders are shipped FREE in the U.S. by USPS Priority Mail (2-4 Days) There are NO shipping costs to add!























SHIP TO:

Name

 

Address

City

State

Zip Code

Phone #

*Email
Address


*Please include your email address if you want us to notify you when your package is shipped.

 

Credit Card Number
Exp. Date and CVV Code

Name/address of Cardholder
if different from above
Type(MC, Visa, AMEX, Discover)

 

 

All of the shipping information above HAS to be completed to ship your order. PLEASE make sure that the shipping address is the same as what the United States Post Office uses since we ship all of our products by the US Post Office! Most orders are shipped within 24 hours of HCGSupplies.com, LLC receiving payment. All prices include shipping if using Priority Mail shipping in the U.S. ALL International and Express Shipping Orders Require a Shipping Fee.

Privacy Statement:
  HCGSupplies.com, LLC will never sell, rent, or otherwise give your information to anyone else....EVER!
Prices subject to change without notice.

By placing this order, I have read and agree to the following:

I have verified that I have selected the correct syringe/needle size option and I understand that HCGSupplies.com, LLC will not exchange the syringes for another size.  I understand that HCGSupplies.com, LLC does not accept returns.  Unopened Orders that are refused are subject to a 5% restocking fee plus the original cost of shipping and will be deducted from my refund. I further understand that any shipping charges paid by me are non-refundable. I understand that HCGSupplies.com, LLC is NOT responsible for lost, stolen or damaged packages.  HCGSupplies.com, LLC cannot be responsible for any delay in the delivery of packages, or for delay by customs inspection of International orders.  I understand that if I enter incorrect shipping information, I must pay the shipping charges when the package is sent a second time.  I also understand that this kit contains only the mixing supplies.  The HCG must be purchased separately.  HCGSupplies.com, LLC DOES NOT sell HCG.

I certify that I am at least 18 years of age.  I will not hold HCG Supplies.com, LLC responsible for any damages caused from the possession and/or use of these supplies. The customer is responsible for knowing all federal, state, and local laws pertaining to the purchase and possession of the products purchased.  I understand that the staff of HCGSupplies.com, LLC are not doctors and do not offer medical opinions or professional medical advice.

If the Blue Print Button above will not work, go to the top of the page in your web browser and Click "File" and then Click "Print"