First Name:
Last Name:
Company Name (if applicable):
Click here if you would like to be added to our mailing list
Email Address:
Phone Number:
(We will only use this number to confirm or ask questions about your order. We will never sell it to any third party.)
Shipping Address:
We will use UPS to ship your order, so please use a street address for shipping.
Please check here if you would like to come in to Basics to pick up your order, and you can skip this section:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MA
MI
MN
MS
MO
MT
ME
NE
NV
NH
NJ
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
z
Billing Address:
Please check here if it is the same as your mailing address
Address Line 1:
Address Line 2:
Address Line 3:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MA
MI
MN
MS
MO
MT
ME
NE
NV
NH
NJ
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
A note regarding shipping charges:
We charge standard UPS shipping charges, which are based on the weight of the package and the zone to which we are sending the product, plus a $1.00 handling fee.
Super Tuesday Shipping:
For Super Tuesday, it works a bit differently. All Supplement or Health & Beauty orders over $50 get FREE SHIPPING! Supplement and Health & Beauty orders under $50 are charged a standard shipping fee of $7.50. Any Super Tuesday order that contains anything other than Supplements or Health & Beauty orders are charged the normal UPS shipping charges, plus a $1.00 handling fee.
Payment Information:
All orders are handled over a secure socket layer (SSL), so your personal information is secure. If you would rather give us your credit card information over the phone, please give us a call at 608/754-3925.
Credit Card Number:
Expiration Date: :
Product Order:
Please provide as much detail as possible about the products you would like to order, including the company name, the size, and a full description of the product you would like. If we have any questions, we will send you an e-mail or give you a call at the number you provided above. If you aren’t sure exactly what you would like to order, send us an e-mail at
info@Basicshealth.com
or give us a call at 608/754-3925. Please remember to submit your order when you are done by clicking the button below.
Quantity
Complete Description of Product
Thanks for being a valued Basics customer!