[Books: Take Charge of Your Health]

Take Charge of Your Health Order Form

This form is used to request copies of the book, Take Charge of Your Health.

The cost of each book is $29. This includes surface mail postage and handling.

I would like to order:

copies

Name:
Address:
AM Phone:
PM Phone:
FAX :
E-mail:

Security Caution

Information you enter on this form is not secure. It is possible for someone other than the intended recipient to view this information while it is being transmitted. If you have any reservations about the vulnerability of your information, it would be wiser to call MIU and submit your information over the phone by calling 1-541-267-2205.

Method of payment: Due to security concerns and cost factors, MIU no longer accepts credit cards for orders. We now accept personel checks or money orders. If you are ordering 1 or 2 copies, we will enclose a statement with your order. If you are ordering more than two copies at a time, please print out this form and send it along with remittance to MIU, 2251 Heather Lane, Coos Bay, Oregon 97420.