Customized Supplements
Order Form



Ready to get started with your customized supplement formula?

Just fill in the form below with all your information. The credit or debit card used will be the card on file and used for each month's supply.

The Priva Test will immediately be sent out and you can expect it within 10 to 14 days. Upon receiving your Priva Test open the box and read the instructions completely.

After collecting your sample, package it up according to the directions and take it to the nearest FedEx or call them for a pickup. (This is included in the pricing).

It will take from 2 to 4 weeks of processing and testing for your first months supply of supplements to arrive.

The cost of the Priva Test is $99.95 and each month's supply of supplements costs $69.95. The cost charged to your card right now will be for the Priva Test in the amount of $99.95 + $6.95 shipping for a total of cost of $106.90.

As soon as your Custom Essentials are formulated and shipped a charge of $69.95 plus $6.95 shipping will appear on your card for a total of $76.90. Each month there after you will be charged $76.90. This is $2.56 a day-less than the cost of a cup of coffee.

Congratulations on taking this all important step to your health and wellness. If you have any questions or need any help, please email us at "customsupplements@health-wellness-4all.com" or use the custom supplements more information form and we will get back to you. If you would like a phone call, please give your phone number and a convenient time to call (please include your time zone).

At this time Custom Essentials is only available throughout the United States of America but will be expanding to other countries soon.

Thanks again and live healthy,
Your friends at Health and Wellness 4All

Note: Your personal information is always kept confidential with us. None of your information will ever be used by us or sold to anyone or any other organization for any other purposes except for those indicated in this order form.



Ideal Health Order Form

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