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	HealthOMeter ELEVATE-C, Digital Eye Level Scale w/Allyn Connex Kit SKU: ELEVATE-C In Stock - Ships within 24 hours		$1,063.00	$1,063.00

1	CardioCheck Lancets, 100 ct SKU: BIO-LAN In Stock - Ships within 24 hours		$40.00	$40.00

1	CardioCheck Triglyceride Test Strips, 6 ct SKU: BIO-TRI-6 Out of Stock		$52.95	$52.95

		Ground, UPS	$13.60	$13.60


			Total	$1,169.55