U.S. & Can. Order Form

U. S. and Canadian Order Form
For Canadian Orders only:
Canadian Purchases complete order form along with Direct E-Transfer Payment
Please e-transfer Canadian Funds of your total order to [email protected]

Disclaimer: This site or Bio-Well technology is not intended to treat, diagnose or prescribe. The information contained herein is in no way to be considered as a substitute for consultation with a duly licensed health care practitioner.
Avertissement : Ce site ou la technologie Bio-Well n'est pas destiné à traiter, diagnostiquer ou prescrire. Les informations contenues dans ce document ne doivent en aucun cas être considérées comme un substitut à la consultation d'un professionnel de la santé dûment agréé.

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Order Form

U. S. and Canadian Order Form
For Canadian Orders only:
Canadian Purchases complete order form along with Direct E-Transfer Payment
Please e-transfer Canadian Funds of your total order to [email protected]

Please Complete Form Below with your full shipping details & phone number

Your Name: (Nom)
Your specific interest in bio-well: Language: English or French

Order Form

U. S. and Canadian Order FormFor Canadian Orders only:Canadian Purchases complete order form along with Direct E-Transfer PaymentPlease e-transfer Canadian Funds of your total order to [email protected]

Please Complete Form Below with your full shipping details & phone number

Your Name: (Nom)Your specific interest in bio-well: Language: English or French

U. S. and Canadian Order Form
For Canadian Orders only:
Canadian Purchases complete order form along with Direct E-Transfer Payment
Please e-transfer Canadian Funds of your total order to [email protected]

Your Name: (Nom)
Your specific interest in bio-well: Language: English or French