INFERA Order Form
Order Date
-
Month
-
Day
Year
Date
Customer & Shipping Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Shipping Urgency
Standard 7-14 Business days (FREE)
Priority 3-7 Business Days ($25)
Express 1-3 Business days ($50)
Thank you for your purchase!
You will receive an email with your order status and tracking number once the form has been processed by our shipping department.Please be on the look for an email containing the product's instructions.Please allow the sales consultant to finish filling up the form.
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Sales Consultant
*
Purchase Amount
Event Name
*
Receipt Number
*
Products for Shipping
Products
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INFERA Mini
$
Free
Quantity
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INFERA
$
Free
Quantity
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BLU Blue Light Therapy
$
Free
Quantity
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Cosmo Full body Device
$
Free
Quantity
1
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3
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10
Full Spectrum Therapy Bed
$
Free
Quantity
1
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Infrared Light Therapy -Capsule
$
Free
Quantity
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Active Vitamin C Serum
$
Free
Quantity
1
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Super Lift Cream
$
Free
Quantity
1
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10
Multi Peptide Eye Cream
$
Free
Quantity
1
2
3
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AHA Repair Serum
$
Free
Quantity
1
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Hyaluronic Boosting Serum
$
Free
Quantity
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10
Jade Mask
$
Free
Quantity
1
2
3
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10
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