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Pulse Health Screening Order Form

To place an order:
  1. Type the items you wish to order in the form below. Please include your name, delivery address and your e-mail address (if you have one)

  2. Print off a copy of this page, then post with your payment to Pulse Health Screening, 46 Gilbert Close, Kempston, Beds, MK42 8RN. Cheques/Postal Orders should be made payable to: Pulse Health Screening. Please do not send cash.

  3. If you have given an e-mail address, you will receive confirmation of your order by e-mail

  4. Your products will be despatched after receipt of payment. Please allow up to 28 days for delivery

Your Details:
Name: Tel No (daytime):
House No/Name: Tel No (evening):
Street: E-mail:
Town: County:
Postcode: Promotion Code (if applicable):

Delivery Details (if different):
Name: House No/Name:
Street: Town:
County: Postcode:

Name of Product
Discount (if applicable) -
Thanks for your order
Add p&p  
Total £
Postage and Packing Rates
Order Value:- £1.00 - £39.99: £3.50;  £40.00 - £49.99: £3.75; £50.00 - £59.99: £3.95;  £60 and above: Free