Order Page   (   Generally, we ship Priority mail within 2-3 business days. Typically, orders take 7-10 days to US addresses, 2-4 weeks elsewhere. Please wait a day or two before calling us. We do not do overnight shipping. Sorry.

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Notes: Please include the extra shipping for orders outside the US. Otherwise, we must cancel your order. Also, no orders from Korea or Italy please. We cannot guarantee delivery.

Or, Print, Fill out, and Mail or Fax the following form to

Peter H. Proctor, PhD, MD, 5555 W. Loop South, Suite 225
Bellaire, Texas 77401

Office: 713-960-1616, FAX: 713-662-2725
>
Payment:
We accept credit cards, checks, or money orders in US currency only.


Name:________________________________________

Street Address___________________________________

City__________________________St.________ postal code______________

Country______________

Credit card #___________________________________________Expires________

Card Member's signature__________________________________

Phone__________________________________

Proxiphen-N (nonprescription ) 2 Months $59.95 ________
4 Months supply $109.95 _________
NANO Shampoo 3 Months supply $39.95 _________
NANO Conditioner 2 Months supply $29.95 ___________

NANO Shampoo and Conditioner $59.95_____________ ($10 Price Savings)
Proxiphen ( Prescription ) 1 Month $100.00_____________
(Requires physican diagnosis---Read first )

*Shipping and Handling, US, $9.50________
*Shipping to Europe or Asia is $38.50.

Total ____________

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Disclaimer: This website is does not create jurisdiction in any state or country other than Texas, United States. Do not read or respond to this website if you deem electronic communication as consent to jurisdiction in a state other than Texas. drp@drproctor.com

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