Order Now and Save! Print this ORDER FORM. Fax (1-781-235-3252) or Mail Order if you do not want to order on-line (www.diabetesandtravel.com) Your choice: Order ON-LINE: (via our secure link) by clicking order next to the item you want to purchase (do not forget to check-out) or PRINT and use this ORDER FORM. QUESTIONS? Call Toll-Free 1-800-549-0095 or 1-781-239-8255 international (Mon-Fri 8:30 AM - 5:00 PM Eastern). Name.....:________________________________________________ Address..:________________________________________________ City.....:_____________________________ Phone: ______________ Zip......:__________________State or Country:______________________ Payment by: ___ Check/Money Order enclosed ___ Charge my credit card ___MasterCard ___VISA ___AMEX ___Discover ___Diner's Club |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Exp. Date: _________ Signature: _____________________________ Please send me: (We can ship to a different address - please indicate) _____ e-pill CADEX Text 12 Alarm Reminder & Electronic Medical Alert Bracelet Wristwatch ($74.95 /rubber strap. Color: __ Silver __ Black) _____ e-pill MeDose Vibrating 6 Alarm Watch with Leather band ($99.95 Color: __ Black & Silver / black band) _____ e-pill MeDose Pediatric Vibrating 6 Alarm Watch with Velcro band ($99.95 Color: __ Red & Blue) _____ e-pill MEDGlider Organizer & 4 Alarm Reminder complete ($45.95 Reminder w/batteries, 7 organizers and Tray) _____ e-pill MD.2 Monitored Automatic Medication Dispenser complete ($799.95 incl. 60 days Free monitoring, complete system including keys (2), cups (100) and Loading Tray) _____ e-pill Multi-Alarm PLUS Easy-to-Set Medication Reminder & Pillbox ($49.95 complete w/batteries) _____ e-pill Multi-Alarm Pill Box Easy-to-Program Medication Reminder ($45.95 w/ batteries) _____ e-pill Pill Bottle Multi Alarm (49.95 for 3 units) _____ e-pill Med-Time Reminder & Automatic Dispenser complete ($259.95 w/batteries, 2 medication trays lock w/ key (2) , prescription card, manual) _____ e-pill 7-Day Organizer & Reminder WORLD's BEST! ($59.95 canvas case, 7 high capacity organizers, electronic reminder _____ e-pill Key-Chain Reminder (TWO for $39.95 w/batteries) _____ e-pill Vibrating Once-A-Day Pendant with Chain (Gold tone). ($59.95 w/battery and Chain) _____ e-pill Pager Vibrating Multi-Alarm Reminder (12 Alarms). Carry it in your pocket, purse or on your belt. ($75.95 w/batteries and Belt Clip) _____ Watch Accessory ($9.95): __ Pendant kit __ Blue strap __ Red strap __ Diabetes __ Medical Condition __ Brown strap _____ e-pill Once-A-Day Medication Reminder ($5.95 2 per pack) _____ e-pill PERS Help-At-Hand Model 911 (No Monthly Fees) PERS system (Special $199.00 complete w cord, AC adapter, manual, main unit, 2 pendants w/ batteries) _____ e-pill Shake Awake Vibrating Alarm Clock ($34.95 complete w/ 3 batteries & pillow strap) _____ Mass residents please add 5% sales tax. _____ Shipping and Handling (FREE Standard Shipping & Handling (US only), Outside U.S.A. $15.00 per order) _____ ORDER TOTAL .... My Time-Zone: ______ (for FREE set-up) MAIL ORDER: 70 Walnut Street Wellesley, MA 02481, USA http://www.epill.com Shipping & Handling: FREE Standard Shipping & Handlin, Outside US $15.00 / order |
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