Organic Juice Pre-Order Form

Full Name

First NameLast Name

Contact Number

Ex. 906-501-7365

Email

Confirmation Emailexample@example.com

Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code

Order

Clean Greens Smoothie$9.00

Cucumber. Spinach. Kale. Chard. Pineapple. Celery. Papaya. Lime Juice.

QuantitySize
Item subtotal:

Everyday Greens Smoothie$9.00

Orange Juice. Apple. Celery. Cucumber. Spinach. Ginger. Lemon Juice

QuantitySize
Item subtotal:

Green Dragon Smoothie$9.00

Strawberry. Blueberry. Raspberry. Dragonfruit. Spinach. Coconut Water.

QuantitySize
Item subtotal:

Orange Dream Smoothie$7.00

Carrot. Orange Juice. Mango. Turmeric. Black Pepper.

QuantitySize
Item subtotal:

Detox Juice$9.00

Apple. Cucumber. Lemon. Ginger. Kale. Celery. Spinach.

QuantitySize
Item subtotal:

Heartbeat Juice$9.00

Beet. Pear. Ginger. Carrot. Celery. Chia Seeds.

QuantitySize
Item subtotal:

Hydration Juice$9.00

Celery. Carrot. Apple. Cucumber. Lemon. Ginger. Turmeric

QuantitySize
Item subtotal:

Summer Greens Juice (seasonal)$6.00

Watermelon. Pineapple. Orange. Spinach. Kale. Chard. Key Lime.

QuantitySize
Item subtotal:

Hibiscus Detox Tea$8.00

12 tea bags of herbal detox tea blend.

Quantity (in packages of 12 tea bags)
Item subtotal:

Wellness Immunity Shot. 2oz shot of pure, cold-pressed ginger, turmeric, orange juice, lime juice, apple juice, and black pepper. Just the right blend to give your body the immunity boost it needs. Drink daily to keep your immune defenses up!

Wellness Immunity Shot$4.00

2oz shot of pure, cold-pressed ginger, turmeric, orange juice, lime juice, apple juice, and black pepper. Just the right blend to give your body the immunity boost it needs. Drink daily to keep your immune defenses up!

Quantity
Item subtotal:

Sea Moss Gel. 12oz bottle of handmade fresh wildcraft St. Lucian Sea Moss gel. Just the right blend to give your body the immunity boost it needs. Packed with 92 of the 102 essential minerals the human body needs to function. It also helps aid weight loss, promotes thyroid health, diabetes health, aids in digestive health, increases mood and energy, etc. Drink 1-2 tablespoons daily for optimal health & wellness.

Sea Moss Gel$25.00

12oz bottle of handmade fresh wildcraft St. Lucian Sea Moss gel. Just the right blend to give your body the immunity boost it needs. Packed with 92 of the 102 essential minerals the human body needs to function. It also helps aid weight loss, promotes thyroid health, diabetes health, aids in digestive health, increases mood and energy, etc. Drink 1-2 tablespoons daily for optimal health & wellness.

QuantityFlavor
Item subtotal:

Pick Up / Delivery Option$10.00

Free Pick Up or Delivery (for a fee) to the following locations: (1) LA Area: Los Angeles, Hawthorne, Inglewood, Culver City; (2) Beach Cities: Santa Monica, Venice, Redondo Beach, Manhattan Beach, El Segundo, Hermosa Beach; (3) LB/SFV/AV: Long Beach, San Fernando Valley, Antelope Valley; (4) Shipping (varies)

Choose One
Item subtotal:

Enter coupon

Total $0.00

Do you have any food allergies? (if none, type N/A)

Please take a moment to read about our Pick-Up/Delivery/Shipping Options Available

Pick Up:

Pick Up available from 9am-noon. Pick up date and address will be provided upon receipt of payment. Please allow 3-5 days from purchase for processing.

Delivery:

Once payment is received (including your delivery fee), you will receive an email to schedule delivery to your address. Please allow 3-5 days from purchase for delivery.

Shipping:

Shipping is available to the United States ONLY. Due to the nature of our fresh organic juices, all juices will be shipped frozen. Shipping fees vary based on location. Minimum shipping fee is $30. You will be contacted after purchase with additional shipping fees, if applicable. Feel free to send an email to info@thenoirenurse.com to inquire about shipping fees to your area prior to your purchase.

STOP! Payment Required to Confirm Your Order!

Please remit full payment of ${order} to:

CashApp: $thenoirenurse; Venmo: @thenoirenurse; or Paypal: paypal.me/thenoirenurse

Your order will not be processed until payment has been received.

Mode of Payment

You are ready to Submit Your Order!

Order*

Order