Ordering enema bags by mail

Internal Cleansing Systems Mail In Order Form

To Order

  1. Please fill out the following form.
  2. Print out this page. (File-->Pint on your browser)
  3. Mail it in with your payment. (Check or Money order)

Product Information

ATTENTION SHIPPING IS INCLUDED IN THE PRICE SHOWN
Kit Type
Quantity (exact duplicates only)


Shipping Information
First Name *
Last Name *
Address *
City *
State
Zip Code *
Country
Email Address *





ATTENTION SHIPING IS INCLUDED IN THE PRICE SHOWN ABOVE:

Make check Payable to:

     Internal Cleansing Systems

Mail Order Form and Payment to:

     Internal Cleansing Systems
     305 W Magnolia #141
     Fort Collins CO
     80521
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