HealthCheckSystems

Billing Address
(As shown on your credit card statement.)
First name * Last name * Company Name Address * Address2 City State\Province: * Zip/Postal Code * Country * Day Phone * Cell Phone Fax Email *
Shipping Address
First name * Last name * Company Name Address * Address2 City * State\Province * Zip/Postal Code * Country * Day Phone * Cell Phone Fax
Payment Info
Name on card * Credit Card number * CVV *

Month *(12) Year*(2025)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	Tot2Walk Toddler Walking Device Aide - BLUE SKU: TOT2BLUE Out of Stock		$20.95	$20.95

1	emWave 6300-BL Personal Stress Reliever, Blue SKU: 6300-BL In Stock - Ships within 24 hours		$199.00	$199.00

1	HealthOMeter 800KLS Professional Home Care Digital Scale,397 x 0.2 lb SKU: 800KLS In Stock - Ships within 24 hours		$84.00	$84.00

		Ground, UPS	$32.30	$32.30


			Total	$336.25