Order Form – (DEMO)

YOUR NEXT TOP SELLING PRODUCT!

Not carrying CofixRX yet? See discounted limited-time introductory pricing below!

Bottles of Nasal and Throat Cleanse

Nasal Cleanse 12pk Display Case

24ct. Rack Pack Display Combo

The Institute for Antiviral Research at Utah State University report about CofixRX.

Bottles of Nasal and Throat Cleanse

Nasal Cleanse 12pk Display Case

Real pharmacists testimonials regarding their experiences selling CofixRX in their pharmacies.

Order Form - Dr. Pham

Company Name

Address Line 1

Address Line 2

City

State

Zip Code

Country

Your Name

Your Email Address

Your Title

Your Phone Number

Limited Time Offers with FREE SHIPPING!

Pricing for EITHER Nasal Cleanse OR Throat Cleanse

Intro Offer 1: $115.20 - “12 Pack Display”

Intro Offer 2: $216.00 - “24 ct. Rack Pack Display”

(20% off - $9.60 per unit, regular price is $159.00)

(25% off - $9.00 per unit, regular price is $303.00)

Offers include counter top display and marketing materials.

MSRP: $19.95 to $24.99

* Complete and submit this form, and we will contact you for details, verification, and confirmation of your order.