ORDERF O R M DR. RATH CELLULAR MEDICINE™ FORMULAS
Order fax: +31 (0)45 71 11 119 Postbus 657 NL – 6400 AR Heerlen E-Mail: info@rath-programs.com IBAN: NL80.ABNA.0505.4511.82 BIC: ABNANL2A
Free Call from UK: 0808-10 11 555* Order hotline: +31 (0)45 71 11 112 Monday – Friday: 08:30 am – 05:00 pm CET
* Free for landline calls from United Kingdom (England, Scotland, Wales and Northern Ireland). Charges from mobile phones may vary.
Online-Shop: https://www.dr-rath.com
I am a new customer, and the ID of my consultant (if known) is:
Single purchase Supscription order I would like to receive my order every two months on the 1st or 15th. I would like to receive my 1st order in ___________________ (Month). Qyt.
EN
Please tick this box if you fax your order again due to an error message.
Art. no. Product
Content
Price €
Qyt.
120 capsules
43,90
0007 Diacor™
90 capsules
43,90
0016 Femicell™
60 capsules
31,90
019 EpiQuercican™
180 capsules
49,90
0027 Osteoforte 035 Royal Complex
120 capsules
37,90
180 capsules
43,90
045 ImmunComplex plus
60 capsules
36,90
047 Lensivit
60 capsules
28,90
60 capsules
37,90
30 capsules
34,90
10001 Basic combination (Art. no. 0001 and 018)
90/60 capsules
84,90
0001 Vitacor Plus
90 capsules
54,90
243 g powder
65,90
018 Dr. Rath‘s Phytobiologicals 036 Dr. Rath’s Probiotics™
60 capsules
39,90
60 capsules
32,90
0002 ImmunoCell™
120 capsules
36,90
0004 Arteriforte 0006 Metavit™
60 capsules
43,90
90 capsules
38,90
0008 Enercor™
60 capsules
43,90
017 Illioforte™
90 capsules
24,90
026 Dr. Rath PhytoPro M™
120 capsules
43,90
037 Balance Control
210 g powder
39,90
048 YouCell™-V 049 YouCell -IQ
NEW!
™
SYNERGY FORMULAS ™
033 Vitacor Plus™ Drink ™
™
Art. no. Product
Content
COMPLEMENTARY FORMULAS 0009 Prolysin C™ 0011 VitaCforte™ 020 Dr. Rath Omega E™ 0023 Dr. Rath Zinc-Selenium Complex™ 0024 Dr. Rath Vitamin B Complex™ 025 Dr. Rath Q10 Complex™ 028 Dr. Rath Omega 3 Vegan™ 030 LyCin™ with Stevia 031 Dr. Rath OPC™ 034 Dr. Rath Magnesium Complex™ 038 Dr. Rath VCP™ 039 Dr. Rath Vitamin D3™ Pocket 040 Dr. Rath Vitamin B12 Pocket 044 Dr. Rath Vitamin D3™ + K2 vegan 046 Dr. Rath VitaC Go! (30 Sticks à 1,6 g) 511 Dr. Rath Vitamin C powder 03011 LyCinTAB
PATENTED FORMULAS
™
I am already a customer, and my customer number is:
On the recommendation of: Name:
0005 Relavit™
™
Total price per delivery
UK Ireland Denmark Finland
3.20 € 12.90 € 5.90 € 12.90 €
Sweden Bulgaria Slovenia Lithuania
Name:
Name:
Adress:
Adress: Zip/Postal code:
Town:
Town:
Country:
Country:
6.90 € 16.90 € 12.90 € 12.90 €
–
–
Email address*: *Please fill in, to receive the latest health information.
Open account payment
SEPA-Direct Debit
METHOD OF PAYMENT
Account holder Please note that it will take 14 days to process your request after receiving the subscription! Vitamin subscriptions are free of charge. Please note: for every change in vitamin subscription there is a charge of 6.90 €. The products are sent at risk of the purchaser. Delivery is subjected to the Dutch regulations. I accept that the data concerning my credit card are registered in your database to allow the payment of my future orders. Moreover, I declare that the invoices of my next orders could be paid with this credit card, unless otherwise specified. www.dr-rath.com. Errors and omissions excepted (01/02/2023 English).
€
Estonia 12.90 € Czech Republic 12.90 € Latvia 12.90 € Other countries: on request
Telephone: DOB:
32,90 25,90 20,90 28,90 29,90 32,90 28,90 41,90 32,90 18,90 24,90 20,90 21,90 21,90 15,90 19,90 28,90
Delivery costs
DELIVERY ADDRESS ( (if different):
120 capsules 120 capsules 60 capsules 90 capsules 90 capsules 60 capsules 60 capsules 420 g powder 60 capsules 90 capsules 90 capsules 150 tablets 120 tablets 90 capsules 48 g powder 100 g powder 90 tablets
Price €
Delivery costs (only for single purchase)
SENDER (Please use capital letters):
Zip/Postal code:
#1445/01-141123EN
Attention: Duplicate faxes!
Place, date and signature (Please sign here for orders. Please also note the signature line in the payment methods).
SEPA-mandate already exists Bank:
IBAN: Swift-Code (BIC):
I/We hereby authorise Dr. Rath Health Programs to withdraw payments from my/our account by way of direct debit trans/actions. At the same time, I/we instruct my/our bank to cash direct debit transactions that are drawn from my/our account by Dr. Rath Health Programs B.V. NB: I/we may request a refund of the debited amount within eight weeks of the debit date. The terms and conditions agreed with my/our credit institute shall apply.
Place, date and Signature