Calculate Payment Medical ID $ Custom Engraving $ 7.00 Wallet Card Qty. ___ x $2.95 = $ Processing (Credit Card Orders Only) Standard 7-10 Days $ 0.00 Shipping & Handling (Must Choose One) Standard Post $ 9.00 Express Post $ 14.00 Medical IDs Save Lives TOTAL OTHER MEDICAL CONDITIONS MEDICINES TAKEN ALLERGIC TO Billing / Shipping Address NAME ADDRESS CITY/TERRITORY POSTAL CODE PHONE EMAIL Please Bill My Credit Card Check/Money Order Enclosed NAME CARD NO. EXP. DATE CVV CODE To Be Engraved Conditions mDiabetes mHypoglycaemia mAngina mAlzheimer’s mHeart Patient mAbnormal EKG mPacemaker mHaemophilia mEpilepsy mSeizure Disorder mRenal Failure mAsthma mMultiple Sclerosis mGlaucoma mVision Impaired Print clearly and attach a separate piece of paper if you require more room. Engraving space is limited, if you need help please give us a call. Mail-in Order Form Mail form with payment to o UMID, PO Box 108, NORTH RYDE, BC NSW 1670 Male Female Age___ (If Child) NAME Shop More Selections at www.Med-ID.com Prices subject to change. Go online for current pricing and products. $ ‘ ‘ ‘‘ There are three members in my family that wear medical IDs. The information on all three medical ID bracelets in my family could mean the difference between life and death. While I know they won’t prevent something bad from happening to me or my loved ones it gives peace of mind knowing that the proper professionals would know how to treat any of us in the event of an emergency. – Eleanor R RECOMMENDED FOR: Diabetes Allergies Heart Disease Blood Thinners Seizures www. Med-ID.com Go online for more styles and other interchangeable IDs! 07.24.17 AUWEB
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Mail-in Order Form - Shop Medical Alert ID Bracelets ......Custom Engraving $ 7.00 Wallet Card Qty. ___ x $2.95 = $ Processing (Credit Card Orders Only) Standard 7-10 Days $ 0.00 Shipping
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Calculate Payment Medical ID $ Custom Engraving $ 7.00 Wallet Card Qty. ___ x $2.95 = $
Processing (Credit Card Orders Only) Standard 7-10 Days $ 0.00
Shipping & Handling (Must Choose One) Standard Post $ 9.00 Express Post $ 14.00
Medical IDs Save Lives
TOTAL
OTHER MEDICAL CONDITIONS
MEDICINES TAKEN
ALLERGIC TO
Billing / Shipping Address
NAME
ADDRESS
CITY/TERRITORY POSTAL CODE
PHONE EMAIL
Please Bill My Credit Card Check/Money Order Enclosed
Print clearly and attach a separate piece of paper if you require more room. Engraving space is limited, if you need help please give us a call.
Mail-in Order FormMail form with payment to o UMID, PO Box 108,
NORTH RYDE, BC NSW 1670
Male Female Age___ (If Child)
NAME
Shop More Selections at www.Med-ID.comPrices subject to change. Go online for current pricing and products.
$
‘‘
‘‘
There are three members in my familythat wear medical IDs. The informationon all three medical ID bracelets in my family could mean the difference between life and death. While I know they won’t prevent something bad from happening to me or my loved ones it gives peace of mind knowing that the proper professionals would know how to treat any of us in the event of an emergency.