Quit Smoking

QuitSmoking.com
Order Form

This order form is provided for your convenience, in case you have difficulty using our automatic shopping cart system. To use our shopping cart, just go to the page displaying the product you are interested in and click the Add to Your Shopping Cart button.

The form below is NOT an online order form. You can use this to print and mail your order to us. However, our shopping cart is IS SECURE, and we recommend that you use it. You can also use our shopping cart to print and mail your order. We recommend you use that option instead of the order form below, but we give you the choice.

We accept Visa, MasterCard, American Express or Discover. You can also mail a check or money order.

Orders within the US are shipped First Class/Priority Mail (3-5 day delivery time, but not guaranteed).

You can order by phone at 770-346-9222. You may also order by fax or by mail. Print this form or hand write the information and send it to us.

If you are ordering by regular
mail, send your orders to:
QuitSmoking.com
3675 Glennvale Ct.
Cumming, GA 30041
United States

 

All orders are Satisfaction Guaranteed: You must be completely happy with your order, or simply return it within 90 days for a full refund (less s/h).

*Don't forget: Buy any product or combination of products totaling $20 or more and receive the special report How to Help a Friend or Loved-One Quit Smoking--absolutely free!

Step One:
Information About You

Mr./Ms./Mrs.
First Name
Last Name
Address
.
City
State
Zip/Postal Code
Country
Email
Daytime Phone
Evening Phone
How did you find our website?
If you choose "Other (please specify)" above,
please tell us how you found us
Comments

Please Note: You must fill in the non-optional (bolded) fields above.

 

Step Two:
Credit Card Information

If you wish to order by credit card, but don't want to transmit your card number, please call us at 1-770-346-9222 or fax your order to 1-770-475-5007. You may also mail your order to the address shown above.

Credit Card: MasterCard Visa American Express Discover/Novus
Credit Card Number
Expiration Date

 

Step Three:
Select the Products You Want

Check all that you wish to order. Please take a moment to calculate the numbers below. Alternately, you may order by using the shopping cart buttons found on each product page. The shopping cart will automatically calculate your order and accept credit card information through a secure server.

Product Quantity Price Each Total
14 Days to Wellness $7.00 $
60 Minutes to a Smoke Free Life $29.95 $
Aroma Works Smokeless - Aromatherapy for Anti-Smoking $14.95 $
Aroma Works Suppress - Aromatherapy for Appetite $14.95 $
Bacc-Off Smokeless Tobacco Substitute pack of 2 cans $4.58 $

Extra Wintergreen

$4.58 $
Butt Out $11.95 $
Cheat & Eat Dietary Supplement $29.95 $
ClearLungs Blue - 60 capsules $15.99 $

Blue - 120 capsules

$27.99 $
ClearLungs Red - 60 capsules $15.99 $

120 capsules

$27.99 $
Curb Your Cravings Nicotine Suppressant patch $39.95 $
Curb Your Cravings Appetite Suppressant patch $39.95 $
Cure Your Cravings audio $14.36 $
Death Cigarette Cards - One (1) Deck $4.00 $

Death Cigarette Cards - Three (3) Decks ($3.75 each deck)

$11.25 $

Death Cigarette Cards - Six (6) Decks ($3.50/each deck)

$21.00 $
Death on Drugs Cards - One (1) Deck $4.00 $

Death on Drugs Cards - Three (3) Decks ($3.75 each deck)

$11.25 $

Death on Drugs Cards - Six (6) Decks ($3.50/each deck)

$21.00 $
Dr. Tung's Tongue Cleaner $7.00 $
Dying to Quit $23.96 $
E-Z Quit Artificial cigarette and 3 flavor cartridges $15.95 $

Four (4) E-Z Quit flavor cartridge refills

$12.95 $

Six (6) E-Z Quit flavor cartridge refills

$15.95 $
Gift Certificates - $10 gift certificate $10.00 $

$25 gift certificate

$25.00 $

$50 gift certificate

$50.00 $
Gum Rejuv™ $11.97 $
How to Quit Smoking Without Gaining Weight (book) $9.97 $
How to Quit Smoking Without Gaining Weight (audio) $12.80 $
Instant Quit Smoking $29.95 $
Ionic Toothbrush $23.97 $
Klean Air Car Ionizer/Freshener $15.97 $
Know Smoking $12.95 $
Lung-Saver $15.95 $
The Last Puff - Ex-Smokers Share the Secrets of Their Success $9.56 $
MacaEase $29.97 $
Meditations for Manifesting compact disc $12.00 $
A Meditation To Help You Stop Smoking cassette $12.98 $

Compact Disc

$17.98 $
A Meditation To Help You With Healthful Sleep compact disc $17.98 $
A Meditation To Help You With Weight Loss compact disc $17.98 $
Never Buy Another Cigarette $59.95 $
NicoBloc $49.97 $
Nicovite Daily Multivitamin for Smokers $12.89 $
Cotinine Urine Test Kit $9.95 $
The No-Nag, No-Guilt, Do-It-Your-Own-Way Guide to Quitting Smoking $6.99 $
No If's, And's or Butts: The Smoker's Guide to Quitting $7.95 $
One Step at a Time $19.95 $
PRObreath Tongue Cleaner $7.00 $
PROgums Brush $7.00 $
QT-Watch $49.95 $
Quit Smoking Auto-matically™ (CD audio) $15.98 $
Quit 'Em $14.95 $
Quit Smoking Bean Bag Bear $9.99 $
Quittin' Time book $14.95 $
Simply Quit $29.95 $
Smart Ashtray $29.95 $
Smoke Control spray - 2 oz $12.95 $
SmokeLessCounter $19.95 $
SmokeRX $49.95 $
The Smoker's Guide to Vitamins and Health $9.95 $
The Smoke Stops Here $12.95 $
Stop Smoking in 7 Days $27.95 $
Stop Smoking With Biofeedback with FREE E-Z Quit artificial cigarette w/3 flavor cartridges $98.95 $
Stress Mints - One Box $5.00 $

Three (3) Boxes

$14.25 $

Six (6) Boxes

$27.00 $
Super Strength Stop Smoking & Automatic Self Discipline audio $10.95 $
There is a Spiritual Solution to Every problem - 6 audio tapes $41.96 $
Total Wellness Meditations Box Set - compact disc $21.97 $

cassette

$21.97 $
Tunguska Blast $49.95 $
Ultimate Respiratory Cleanse™ $11.50 $
Vimaca for Women $39.97 $
Zero Nicotine - One Box $49.95 $

Two Boxes

$79.90 $

Three Boxes

$98.85 $
(Special Bonus Report if subtotal is $20 or more) Subtotal $
(Georgia residents only, add 7%) Tax $
(All Orders: Shipping for US and Canadian orders is $4.95, no matter how many items you order. Shipping for most orders in other countries is also $4.95, but may be higher. If you have questions about shipping cost, submit a
Shipping Question) Shipping
$4.95
(US orders only. For 1-2 day shipping {Mon-Sat, excluding holidays} add $14.05) Express Mail $
Grand Total $

 

Please remember you can NOT submit this order form online. It is here in case you need to print and mail your order to us.

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