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MENU ITEMS HAVE CHANGED. YOU MUST READ ALL ENTERIES BEFORE MAKING SELECTION

Do not change cleanse drinks. These have been created scientifically and we recommend consuming them in the order they come

** When using this system you must allow 1 week to prepare the order (Advise customer of delay if such pertains an issue) **

EACH CUSTOMER MUST HAVE THEIR CLEANSE SUBMITTED SEPARATELY!

PICKUP DAYS ARE FRIDAYS & SUNDAYS.
ORDERS MUST BE PLACED A WEEK IN ADVANCE.

Customer name

Customer Email

Customer Phone

Order Type

Master Cleanse

Vitamin Guru

Repair & Enhance

Signature Detox

Custom Juice Order

Cleanse Duration

Pickup Location

Pickup Date

** If more then 3 days of cleanse you must enter the next pickup date in the field on the right**

IMPORTANT: Cleanse order cutoff time is 3pm. Orders must be placed 48 hours in advance. Pickup days are Friday & Sunday only.

Pickup Date (Select only if more then 3 days)

** If more then 6 days of cleanse you must enter the next pickup date in the field below**

Pickup Date (Select only if more then 6 days)

Please use this field to schedule a pickup date for cleanses over 6 days

Payment via:

Order paid by cash or credit card?

Message

Please write any comments or notes above

Was customer notified that all bottles must be picked up at once?

** ONLY 3 day cleanse per submission.
If 4 days of cleanse or more you MUST enter new pickup date in the date field above**

Employee Name

Prepared by:

(For cold press room use only)

Real email address is required to social networks