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Barbara Thompson
Products Order Form
(Please Print Clearly)
Call 877-440-1518 with questions |
Mail this form with check to:
WLS Center
488 Diablo Drive
Pittsburgh, PA 15241 |
| Name |
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| Address |
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| City, State, Zip |
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| Phone Number |
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Email Address |
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Products
(For information on these products, go to http://www.WLScenter.com/1shopmain.htm) |
Price |
Quantity |
Enter $
Line Total |
| Book: Weight Loss Surgery: Finding
the Thin Person hiding Inside You |
$18.95 |
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| Book: Weight Loss Surgery for
Dummies |
$14.95 |
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CD: Barbara Thompson Live
(Best for new or prospective patients) |
$14.95 |
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| CD: Post-Op Perils |
$14.95 |
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| CD: Emotional Eating |
$14.95 |
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| CD: Exercise |
$14.95 |
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| CD: Plastic Surgery |
$14.95 |
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| CD: Food |
$14.95 |
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Sub Total |
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Add 7% of Sub Total for Shipping and Handling
(Minimum $5) |
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Pennsylvania Residents add 7% |
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Check Amount Total |
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Referred By: |
| Name: |
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| Address |
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| City, State, Zip |
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| Phone Number |
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Email Address |
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