Orderform Dr. Rath Health Programs - EN

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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

Single purchase Supscription order

I would like to receive my order every two months on the 1st or 15th.

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.

I would like to receive my 1st order in (Month). I am a new customer, and the ID of my consultant (if known) is:

On the recommendation of:

Name:

SENDER (Pleaseusecapitalletters):

DELIVERY ADDRESS ( (ifdifferent):

Name:

Adress:

I am already a customer, and my customer number is:

Place, date and signature (Please sign here for orders. Please also note the signature line in the payment methods).

EN
#1445/01-010624EN
Adress: Zip/Postal code: Town: Country: Telephone: DOB: – –Email address*:
Name:
Attention: Duplicate faxes! Please tick this box if you fax your order again due to an error message. UK 3.20 € Ireland 12.90 € Denmark 5.90 € Finland 12.90 € Sweden 6.90 € Bulgaria 16.90 € Slovenia 12.90 € Lithuania 12.90 € Estonia 12.90 € Czech Republic 12.90 € Latvia 12.90 € Other countries: on request Delivery costs METHOD OF PAYMENT Place, date and Signature SEPA-Direct Debit SEPA-mandate already exists Account holder 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. Open account payment 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). *Please fill in, to receive the latest health information Qyt. Art. no. Product Content Price € COMPLEMENTARY FORMULAS 0009 Prolysin C™ 120 capsules 32.90 0011 VitaCforte™ 120 capsules 25.90 020 Dr. Rath Omega E 60 capsules 20.90 0023 Dr. Rath Zinc-Selenium Complex™ 90 capsules 28.90 0024 Dr. Rath Vitamin B Complex™ 90 capsules 29.90 025 Dr. Rath Q10 Complex™ 60 capsules 32.90 028 Dr. Rath Omega 3 Vegan™ 60 capsules 28.90 030 LyCin with Stevia 420 g powder 41.90 031 Dr. Rath OPC™ 60 capsules 32.90 034 Dr. Rath Magnesium Complex™ 90 capsules 18.90 036 Dr. Rath’s Probiotics™ 60 capsules 32.90 038 Dr. Rath VCP™ 90 capsules 24.90 039 Dr. Rath Vitamin D3™ Pocket 150 tablets 20.90 040 Dr. Rath Vitamin B12 Pocket 120 tablets 21.90 044 Dr. Rath Vitamin D3™ + K2 vegan 90 capsules 21.90 046 Dr. Rath VitaC Go! (30 sticks à 1,6 g) 48 g powder 15.90 050 Dr. Rath VitaKids Immune NEW! 60 tablets 31.90 511 Dr. Rath Vitamin C powder 100 g powder 19.90 03011 LyCinTAB 90 tablets 28.90 Delivery costs (only for single purchase) Total price per delivery € Qyt. Art. no. Product Content Price € PATENTED FORMULAS 0005 Relavit™ 120 capsules 43.90 0007 Diacor™ 90 capsules 43.90 0016 Femicell™ 60 capsules 31.90 019 EpiQuercican™ 180 capsules 49.90 0027 Osteoforte™ 120 capsules 37.90 035 Royal Complex 180 capsules 43.90 045 ImmunComplex plus 60 capsules 36.90 047 Lensivit™ 60 capsules 28.90 048 YouCell -V 60 capsules 37.90 049 YouCell™-IQ NEW! 30 capsules 34.90 SYNERGY FORMULAS 10001 Basic combination (Art. no. 0001 and 018) 90/60 capsules 84.90 0001 Vitacor Plus™ 90 capsules 54.90 018 Dr. Rath‘s Phytobiologicals 60 capsules 39.90 0002 ImmunoCell 120 capsules 36.90 0004 Arteriforte™ 60 capsules 43.90 0006 Metavit™ 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
Cellular Medicine Formulas Orderform Online-Shop: https://www.dr-rath.com
Zip/Postal code: Town: Country:
Dr. Rath

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