We accept only Money Orders in US Dollars made payable to: Jacqueline Feeman
Request Form
200 Starcrest Drive, Apt 3, Clearwater, Florida 33765
(727) 729-8352
Date:
E-mail:
@
Item
Sheet/Size
Sheets/Box
Price/Each
Quantity
Price*
1
Salonpas
®
2.56" x 1.65"
20
$3.00
$
2
Salonpas
®
2.56" x 1.65"
40
$5.00
$
3
Aqua-Patch
®
3.94" X 5.51"
5
$7.50
$
4
Air Salonpas
®
80 ml
Spray
$13.50
$
5
SinSinpas
®
150 ml
Aerosol
$8.50
$
6
Tawase Cloths
11" x 35"
Each
$5.50
$
7
$
Check if International Orders (Add Surcharge $3.50)
$
Total:
$
Instructions:
Please substitute if item is not available. (We will not substitute if this box is not selected.)
Please e-mail me for instructions if item not available. (E-mail address required. See our
privacy info
.)
Please notify me by e-mail when product is shipped. (E-mail address required. See our
privacy info
.)
Click here for more information
* Price includes shipping, handling, and taxes (taxes are paid when we buy the product locally for you).
** Please contact us for estimate before ordering.
Notes:
• This website is a non-profit extension of
Ampuku
®
Wellness Therapy
. We are offering only to obtain products you cannot
obtain locally and do not otherwise produce, manufacture, nor distribute any products.
•• All products shipped by surface mail/parcel post. Air or Express Delivery charges are substantially more.
••• Due to availability and pricing of our local sources, items & prices subject to change without notice.
•••• E-mail is formatted to prevent harvesting of your e-mail address
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We accept only Money Orders in US Dollars made payable to: Jacqueline Feeman
Request Form