All major Credit Cards accepted

SPECIALIST PROVIDERS OF PHARMACEUTICALS BY MAIL ORDER.

TO ORDER PROPECIA ONLINE >>CLICK HERE<<

HOW TO ORDER PROPECIA BY FAX OR POST

• PRINT OUT THE ORDER FORM BELOW (use the 'print' button on your browser or select 'file' & 'print' from the menu).
• ENTER YOUR NAME & ADDRESS DETAILS AND THE QUANTITY YOU WISH TO ORDER.
• ENTER YOUR CREDIT CARD DETAILS (IF FAXING OR POSTING)

  OR

• ENCLOSE A CHEQUE/PO WITH YOUR ORDER (IF POSTING).

THEN EITHER;-

1. POST TO THE ADDRESS BELOW -

OR

2. FAX TO (44) -1481 - 832919

DON'T FORGET TO INCLUDE YOUR CHEQUE OR CREDIT CARD DETAILS.

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OUR PRICES ARE FULLY INCLUSIVE

Orders are despatched in unmarked and discreet packaging, and will be despatched on a first come, first served basis from our UK-registered Pharmacy.

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Goods are despatched tax-free in the EU, but DRM cannot be responsible for local taxes or import restrictions which may apply in other countries.

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ORDER FORM

PROPECIA

PLEASE TICK THE QUANTITY YOU REQUIRE BELOW;-

3 months supply = £169.00	_____
6 months supply = £287.00	_____

£ = $?, FrF?, Kr?, DM?, YOUR COUNTRIES CURRENCY? - EXCHANGE - CHANGE - CONVERT

YOU PAY NO MORE!

NO SEPARATE CONSULTATION FEE - NO HIDDEN COSTS - POSTAGE AND PACKING TO ANY COUNTRY INCLUDED

Goods are despatched tax-free in the EU, but DRM cannot be responsible for local taxes or import restrictions which may apply in other countries.

OTHER CURRENCIES? -- Orders will be applied to your credit card in UK pounds, the amount wil be automatically debited (in your own currency), at the rate prevailing on the day of transaction by the credit card company -

* IMPORTANT !!!!!

Standard medical practice requires your General Practitioner / Doctor to be aware of any medication prescribed to you.
PLEASE SELECT ONE OF THE FOLLOWING OPTIONS
* I take responsibility for advising my G.P./ Doctor.	YES / NO
*I would like DRM to advise my G.P./Doctor His / Her name and address are;-	YES / NO
Do you suffer from hair loss ?	YES / NO
Do you suffer from any allergies ? If yes, please enter details below	YES / NO
Have you ever been checked for (or diagnosed with) prostate cancer? If yes, please enter details below	YES / NO
Are you taking any other medication (including non-prescription)? If yes, please enter details below	YES / NO
I am;	MALE / FEMALE
Please enter any comments or details (e.g. drugs taken) in this space

I confirm that I have read and understood the information given and that the above information is the truth to my certain knowledge. I understand that women should not handle the tablets (especially if broken or damaged) and that I should wear a condom during intercourse if there is any risk of pregnancy (Propecia may be concentrated in the semen). I accept full responsibility for my use of the supplied drugs.

*Signature ____________________ Entering your name here signifies acceptance of the above statements) Date _____________________ *Date of Birth ______/______/______

(DRM are not responsible for local taxes or import restrictions which may apply in your country)

I enclose cheque/PO for £________ payable to 'DRM Ltd'

or

Please debit my Access / Visa / Mastercard No ............. / ............. / ............. / .............

Expires ............. / ..............

DESPATCH TO;

* NAME ..................................................................................................................

* ADDRESS ............................................................................................................

.............................................................................................................................

COUNTRY...............................................................................................................

* PHONE NUMBER ........................................................................

* POST/ZIP CODE .................................

* EMAIL..............................................................................

NAME & ADDRESS ON CREDIT CARD (if different) ...............................................

.............................................................................................................................

.............................................................................................................................

HAVE YOU ORDERED via drm BEFORE ? - - - YES / NO

HOW DID YOU LEARN OF DRM?... Search engine / Newspaper / Magazine / Website link / Other

Please Specify ..............................................................................................................................

If a search engine, what search word(s) did you use?

..............................................................................................................................

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ABOUT DRM HOME

Translate this page!

to German to French to Italian to Spanish to Portuguese
Systran by Alta-Vista Translation Services

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PROPECIA - for hair loss	PRICES	ORDER FORM
ACOMPLIA - for weight loss	PRICES	ORDER FORM
CIALIS - for impotence	PRICES	ORDER FORM
VIAGRA - for impotence	PRICES	ORDER FORM
REGAINE EXTRA STRENGTH - for hair loss	PRICES	ORDER FORM
UPRIMA - for impotence	PRICES	ORDER FORM
XENICAL - for weight loss	PRICES	ORDER FORM

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Click here to return to Propecia Sales Home page

Click here to mail the Webmaster

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Direct Response Marketing Limited. 38 Apsley Road, St Helier, Jersey. Channel Islands. JE2 4LR. Telephone; 0845 121 6667 (UK local rate) Fax; 0845 121 6669 (UK local rate) International Telephone (44) 1534 510271 International Fax (44) 1534 510272 General Enquiries - email: Email DRM Order Enquiries - email: Email order dept

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XENICAL is the trademark of F. Hoffmann-La Roche Ltd Propecia is the trademark of Merck & Co., Inc. Viagra is the registered trademark of Pfizer Inc. NY. All other trademarks are acknowledged as being the property of their respective owners