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Birth
Trauma: A Modern Epidemic
The Cause of the First
Subluxation
with Dr. Jeanne Ohm
Print and Fax this order form to: 1 310 301-4438
You can also reach us by mail at:
Planet
Chiropractic
2509 Ocean Ave., Venice, CA 90291
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Quantity of
"Birth
Trauma"
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___________
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@
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$149.00 per
video (ntsc)
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Shipping per
order
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______$6.00
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(US)
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Shipping per
order
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______$9.00
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(Canada
& International)
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Total Due
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(prices in US funds)
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Ship to:
_____________________________________
_____________________________________
_____________________________________
Phone: ______________________________
Bill to:
_____________________________________
(if different from shipping)
_____________________________________
_____________________________________
Phone: ______________________________
VISA
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Credit Card #____________________________________ Expire Date__________
Signature_________________________
Today's Date___________
Check Enclosed__________
(Please make checks payable to:
Planet Chiropractic)
Your email address
___________________________ (so
we can notify you via email)
Thank You For Your Order
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