NHPlus.com
My Order List
Customer Name: _____________________________________ Phone: __________________________
Billing Address : _________________________________________________________________
City: ________________________________ State: __________________________ Zip Code: ________________
Eamil: ________________________________________________________________________
Ship to Name: _____________________________________ Phone: __________________________
Ship to Street: _________________________________________________________________
Shpi to City: ___________________________________ State: __________________________ Zip Code: ________________
If you like to pay by credit card, please fill out the above information, then print a copy and fax it to us. If you like to pay by check or money order, please make check payable to

Natural Healing Plus
6481 Orangethorpe Ave., Suite 8
      Buena Park, California 90620 USA

Phone: (562) 429-6888
Fax: (562) 366-9355
Credit Card No: __________________________________________________

CVV2 Code: _______(last 3 digits code on the back of your credit card)

Exp Date: _____ / _______ (mm/yyyy)