Pure Wellness Collection Order Form 
Complete the form if you would like to order the Pure Wellness Collection Kit  or want more information about the Cancer Care Product Line. The information provided will allow me to send you an invoice for the Pure Wellness Collection Kit only. Once the invoice is paid, the order will be placed. The invoice will also include the shipping charges. 

If you would like to shop my iS Clinical Store, then please use use this link SHOP MY IS CLINICAL STORE
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First Name *
Last Name *
Would you like to purchase the Pure Wellness Collection Kit?  Includes 1 Cream Cleanser (120 ml);1 Poly Vitamin Serum (15 ml); 1 HydraCool Serum (15 ml); 2 Extreme Protect SPF 30 (5 g). The price is $135 *
Email Address to send Invoice *
Pure Wellness Collection $135
Mobile Number *
Shipping Address *
Use this link to purchase individual items from the Cancer Care Product Line if you DO NOT want the Pure Wellness Collection Kit. The items in the Cancer Care Line are listed below. 
Please write any questions that you may have about the Cancer Care Line. 
Do you want Alva to contact you about any of the products? *
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