ANAGEN.NET - ONLINE ORDER FORM PHARMACY NATUROMEDS

Product Overview Naturomeds All Online Shopping Anagen.net  Online currency converter

CHOICE

Amount / Price

Cardiofit (lipid lowering and cardiac protection)

Erectus Gel (local rub for erectile dysfunction)

Euphoria Pheromones Cologne (female attractant for man use)

Euphoria Pheromones Perfume (male attractant for woman use)

Hangoff (anti hangover)

Hoodia (appetite suppressant)

Last-Longer (premature ejaculation)

Libup (libido enhancer for woman)

Lyse XL (weight loss)

Maxdude (penis enlargement)

Maxodent (dental whitening strip)

Menoaid (Menopause aid)

Mx Man (penis enlargement)

Muscomax (muscle build supplement)

Nervshield (anti stress)

No-Gasp (anti asthmatic)

Ovusure (timely ovulation)

Profinast (anti hairloss)

Revive (anti stress massage oil)

Snooz (for sound sleep)

XtraCum (sperm enhancement)

Zero Nico (anti smoking)

   
SHIPPING CHARGES
USA orders Registered Express Mail US$ 11.00
INTERNATIONAL
orders Registered Express Mail US$ 14.00
 
INTERNATIONAL
orders Fast Ship Couriers US$ 26.00

SHIPPING WORLDWIDE

 
   
SHIPPING DATA (* required field)
Please enter the data correctly

First and Last Name *

E-Mail Address *

Street and Number *

City *

State / Province *

Postal Code / ZIP *

Country *

Telephone Number *

Comments or additional information for the delivery

CREDIT CARD INFORMATION (required fields)

 

Other Credit Card

Card Holder's Name

Credit Card Number

Please carefully enter the 15 or 16 digit credit card
Expiration Date
Month Year

Credit Card does not expire 

Security Code (CVV or Card Id)
(on the back of your credit card is 3 digits or 4 digits if American Express)  Where is my Card Id ?
Please enter the correct security code

Card Holder Address (if different from shipping data)

 
Please you write the correct result 1 + 9 =  
SEX MFHeight (you have to specify if inches or cms)
 
Do you smoke? YESNODo you drink alcohol? YESNO
Are you allergic to any medication? YESNO If so,please specify
Are you taking any medication presently? YESNO If so,please name them
 
Do you have any of the following medical problems?
 
Coronary Heart disease
Congestive Heart failure
Valvular heart disease
Hypertension
Stroke
Atherosclerosis
Obesity
Thyroid Disease
Diabetes Mellitus
Any other endocrine disorder 
Spinal cord injury
Depression
Anxiety
Liver disease
Kidney Disease
Prostate Cancer
Enlarged prostate
Low testosterone
Anaemia
Any other problem

The information I give will remain the property of the physician reviewing them, will remain confidential and released only with my consent to give notice of any changes in my health.

Yes, I desire to receive the medical consultation free

Please consult your own doctor regarding any drug interactions or side effects.

The information provided in relation to these products is supplied by the manufacturers and we accept no liability or responsibility as to the accuracy of the information supplied.

Yes, I agree

Where did you see our web address? 

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