Orderform
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. Art. no. Product
Content
PATENTED FORMULAS 0005 Relavit™ 120 capsules 0007 Diacor™ 90 capsules ™ 0016 Femicell 60 capsules 019 EpiQuercican™ 180 capsules 0027 Osteoforte™ 120 capsules 035 Royal Complex 180 capsules 045 ImmunComplex plus 60 capsules 047 Lensivit™ 60 capsules ™ 048 YouCell -V 60 capsules SYNERGY FORMULAS 10001 Basic combination (Art. no. 0001 and 018) 90/60 capsules ™ 0001 Vitacor Plus 90 capsules 018 Dr. Rath‘s Phytobiologicals™ 60 capsules 0002 ImmunoCell™ 120 capsules ™ 0004 Arteriforte 60 capsules 0006 Metavit™ 90 capsules 0008 Enercor™ 60 capsules ™ 017 Illioforte 90 capsules 026 Dr. Rath PhytoPro M™ 120 capsules 037 Balance Control 210 g powder ™ 0049 WellUp IQ Daily BACK AGAIN! 30 capsules 051 WellUp™ Recharge NEW! 60 capsules Delivery costs UK Ireland
EN
Please tick this box if you fax your order again due to an error message.
3.20 € 12.90 €
Denmark Finland
5.90 € 12.90 €
Sweden Bulgaria
I am already a customer, and my customer number is:
On the recommendation of: Name: Price €
Qyt. Art. no. Product
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™ 0036 Dr. Rath’s ProCultura NEW! ™ 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) 050 Dr. Rath VitaKids Immune 511 Dr. Rath Vitamin C powder 03011 LyCinTAB
43.90 43.90 31.90 49.90 37.90 43.90 36.90 28.90 37.90 84.90 54.90 39.90 36.90 43.90 38.90 43.90 24.90 43.90 39.90 34.90 39.90 6.90 € 16.90 €
Content
32.90 25.90 20.90 28.90 29.90 32.90 28.90 41.90 32.90 18.90 32.90 24.90 20.90 21.90 21.90 15.90 31.90 19.90 28.90
Total price per delivery
Slovenia Lithuania
12.90 € 12.90 €
Estonia 12.90 € Czech Republic 12.90 €
DELIVERY ADDRESS ( (if different):
Name:
Name:
Adress:
Adress:
120 capsules 120 capsules 60 capsules 90 capsules 90 capsules 60 capsules 60 capsules 420 g powder 60 capsules 90 capsules 60 capsules 90 capsules 150 tablets 120 tablets 90 capsules 48 g powder 60 tablets 100 g powder 90 tablets
Price €
Delivery costs (only for single purchase)
SENDER (Please use capital letters):
Zip/Postal code:
#1445/01-121026EN
Attention: Duplicate faxes!
Zip/Postal code:
Town:
Town:
Country:
Country:
€
Latvia 12.90 € Other countries: on request
Telephone: DOB:
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Email address: Open account payment
Place, date and signature (Please sign here for orders. Please also note the signature line in the payment methods).
SEPA-Direct Debit
METHOD OF PAYMENT
Account holder
SEPA-mandate already exists Bank: Place, date
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 (01/10/2026 English).
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.
Signature By placing this order, I confirm that I have read and understood the Terms and Conditions and the Privacy Policy. These are available at https://shop.dr-rath.com/en-us/stc and will be sent free of charge on request.