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Order Form - for Pharmacies, Retailers and Bulk Purchasers

Using the form you may request the current price list.

You want to order by fax? Please contact us. We will send you an orderform.

Please send me your current price list for retailers
    Name / company**:

No delivery charges if order exceeds €150 merchandise value (inside Germany)

Inland delivery €4.90
Delivery inside the EU €9.90

Period allowed for payment: 15 days net (inside Germany)

Other countries please contact us for delivery conditions.
    Contact:
    Street:**
    Town / city:**
    Post code:**
    Email:**
    Phone:**
    Fax:
 
   

**Mandatory fields: Please fill in. We are afraid that without these details we are unable to process your order.