Organic Juice Pre-Order Form

Full Name*

First NameLast Name
Contact Number*
Ex. 906-501-7365
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Confirmation Emailexample@example.com
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Street Address

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Order*

product

Clean Greens Smoothie$9.00

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

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Everyday Greens Smoothie$9.00

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

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Green Dragon Smoothie$9.00

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

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Orange Dream Smoothie$7.00

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

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Detox Juice$9.00

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

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Heartbeat Juice$9.00

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

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Hydration Juice$9.00

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

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Summer Greens Juice (seasonal)$6.00

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

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Hibiscus Detox Tea$8.00

12 tea bags of herbal detox tea blend.

Quantity (in packages of 12 tea bags)
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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!

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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.

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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)

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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.
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