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Order Type* :

Name* :

Number* :

Email* :

Address* :


Payment: Payment due on invoice.

Cancellation Policy: All orders are fixed. Store credit is offered.

Delivery: Only available in Vancouver.

Bottle Deposit is included.

# of Days

Revive Basic ($65/day)
Revive w/ Nut Mylk ($75/day)
Revitalize Active ($80/day)
Revitalize w/ Nut Mylk ($88/day)
21 Day Cleanse ($1240)
21 Day Cleanse w/ Nut Mylk ($1340)

Full amount provided on invoice.

Pickup/Delivery Date:

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