Direct Response Marketing (Jersey) Limited, jersey, channel islands. Mail Order Online Pharmacy.
Viagra, Propecia, Cialis, Uprima, Xenical, Avodart, Regaine (Minoxidil). Treatments for impotence, hair loss and weight loss.  
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering. Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
 All major Credit Cards accepted
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
48 HOUR DELIVERY - ALL PRESCRIPTION PRODUCTS - UK MAINLAND (NOT INCLUDING HOLIDAYS/WEEKENDS)
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.

Product information

PLEASE NOTE - DRM are no longer able to ship to the USA or Canada

BESTELLUNG XENICAL BESTELLUNG XENICAL

If you have any problems, please CLICK HERE to let us know.

PLEASE NOTE - This is a non-secure version of the order form. To access the secure version please CLICK HERE
If you prefer to fax or post your order, please CLICK HERE

XENICAL - MEDICAL DECLARATION

Please complete all the following fields;
(Fields marked IN RED (*) are mandatory)
    TITLE (Mr,Mrs,)
    FIRST NAME
    *
    FAMILY NAME
    *
    YOUR HEIGHT
    *
    YOUR WEIGHT
    What sex are you? (YOUR GENDER - MALE or FEMALE)
    *
    MALE (MAN)
    FEMALE (WOMAN)
    Email.
    *
    Date Of Birth.
    *
    Do you suffer from Diabetes?

    * YES NO

    Do you suffer from Anaemia?

    * YES NO

    Do you suffer from Liver Disease?

    * YES NO

    Do you suffer from Bowel Disorders?

    * YES NO

    Do you suffer from Under-Active thyroid?

    * YES NO

    Do you suffer from Vitamin Deficiency?

    * YES NO

    Do you suffer from Crohn's Disease?

    * YES NO

    Do you suffer from Ulcerative Colitis?

    * YES NO

    Are you pregnant or breastfeeding?

    * YES NO

    Are you taking Steroids?

    * YES NO

    Have you been prescribed Xenical before?
    (Any previous prescription, either from your own doctor or from another supplier)
    * YES NO
    Is there any reason why you believe you may not be able to take XENICAL?

    DRM advise you to discuss any concerns about this questionnaire or the use of XENICAL with your own Doctor.

    * YES NO

    Check this box if you would like the doctor to contact you about your condition.
    you can also contact our doctor for more advice at any time by using this link Email Doctor
    YES, I would like the doctor to contact me.
    (Please enter details below.)
    Please use this field to add details of any medication taken or to expand further on the above questions if necessary, or to tell us more about your problem so that our doctor can help you further.

Standard medical practice requires your General Practitioner / Doctor to be aware of any medication prescribed to you.

    I take responsibility for informing my G.P. / Doctor
    * YES NO

If you have selected "NO", you must enter your doctors name and address below, so that DRM can inform them

    SIGNED *


    Please type your name here to signify your acceptance of the above statements

TOTAL DISCRETION IS ASSURED - YOUR DETAILS WILL NEVER BE PASSED ON TO A THIRD PARTY.


ORDER FORM

XENICAL

    DESPATCH ADDRESS

    *

    *

    COUNTY / AREA

    *

    COUNTRY

    *

    ZIP/POST CODE

    *

    FAX NUMBER

    DAYTIME TEL NO

    PLEASE SUPPLY;-

    *

    ALL PRICES ARE IN U.K POUNDS STERLING ()

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.

Each month's supply is 84 capsules (3 capsules per day for 28 days) of 120mg Orlistat (manufactured by F. Hoffmann-La Roche Ltd). A capsule is taken only with each main meal consumed, so 84 capsules may last longer than 28 days.

    N.B. - Packaging and quantities in some territories may differ slightly from the above

    Please debit my credit card.

    *

    Please enter 'XXXX' if any field is left blank after entering your number
    We accept Visa and Mastercard.
    Expiry date of card

    *

    Switch issue number (if applicable)
    Credit Card Security ID (if available):
    Illegible
    *In an effort to reduce fraud we are asking for the Security ID for the cards listed below. If your card does not have a Security ID on it you may leave the field blank. If the Security ID on your card is unreadable, you should check the "Illegible" box. See the link below for an image of the location of the Security ID on your card.
    Visa / Mastercard - Security ID (if available) is printed on back of card after the credit card number.
    Name (as it appears on card)

    *

    Please acknowledge;-
    I am aware that my order will be charged in (GB Pounds sterling) and the exchange rate will be determined on the day of transaction

    * YES

    Please enter your name and email address here, so that we can acknowledge your order

    Name *

    Email *

    e.g. [email protected]'

    Have you ordered via drm before?
    * Yes No

    (This will help us to process your order more efficiently)
Please check that you have answered ALL the questions.

Some browsers will not retain the form data and you may need to complete the form again.

The order may take a few moments to process.

Please press the button below only once and wait for the acknowledgement page. Thanks.

PLEASE NOTE; - Once your order is placed we may not be able to cancel or change it.
If you made a mistake when ordering, please contact us immediately preferably by phone or email.

UK law forbids the pharmacy from accepting back any prescribed medications once despatched.


This is a secure online order form that uses server encryption to protect your personal data.


propecia sales
Concerned about ordering online?

About secure ordering online

Read our customer feedback

Read our Privacy Statement and Customer Guarantee

ALL PRICES ARE IN U.K POUNDS STERLING ()

The price includes;- your consultation fee !
OTHER CURRENCIES? -- orders will be applied to your credit card in U.K. Pounds, the amount will automatically be debited in your own currency, at the rate prevailing on the day of transaction by the credit card company.

    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.

    Your order will normally be despatched on the day of your order if we received it before 1P.M (not weekends or holidays). Orders to the UK should arrive within 48 hours. Please allow 7 working days to Europe, 15 working days to rest of the world.

    YOUR GUARANTEE! - If your goods do not arrive for any reason, DRM will re-ship or refund your order!


VIAGRA : XENICAL : PROPECIA : AVODART : CIALIS : LEVITRA : ORDER REGAINE (Minoxidil) :
PRODUCT INFORMATION : OTHER PRODUCTS? : LOST? - SITE MAP : DRM HOME

Direct Response Marketing (Jersey) Limited.

Suite 15 Burlington House, St Saviours Road, St Helier, Jersey, British Channel Islands. JE2 4LA
Telephone; 0845 121 6667 (UK local rate)
Fax; 0845 121 6669 (UK local rate)
International Telephone (44) 1534 510271

General Enquiries - email: Email DRM: Order Enquiries - email: Email order dept
All trademarks are acknowledged as the property of their respective owners.


89.145.89.36