Natural Treatments for Tics and Tourettes

A Patient and Family Guide 
 

Please print this page and then fill in the fields below

 

Name__________________________________________Date ___________________________________

Address________________________________________________________________________________

City__________________State/Prov._______________Zip/Code____________Country_______________

 


Make check or money order payable to ACN
Association for Comprehensive NeuroTherapy



Credit cards
accepted in USA:
Visa, MasterCard, Discover, Am. Express


Outside  USA:

Visa & MasterCard only


Card #: _____________________________

Expiration Date: ______________
Phone or e-mail: _______________________



Mail to:

ACN Book Order
P.O. Box 2198
Broken Arrow, OK 74013

 

or


Fax to:
561.798.9820


 
 
       


Book Cost: $19.95

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USA    
Quantity:    
___  @ $19.95/ book = $_______  
     
Shipping & Handling        
$6.50 per book           = $_______  
     

Total Amount  

= $_______  

- - - - - - - - - - - - - - - - - - - - - - - - - -

Canada and Mexico    
Quantity:    
___  @ $19.95/ book = $_______  
     
Shipping & Handling        
$10.00 per book           = $_______  
     

Total Amount  

= $_______  

- - - - - - - - - - - - - - - - - - - - - - - - - -

Other Countries    
Quantity:    
___  @ $19.95/ book = $_______  
     
Shipping & Handling (Air)    
$16.00 per book           = $_______  
     

Total Amount  

= $_______