We conveniently accept all forms of payment including checks, money orders, etc. Personal checks normally take up to 2 weeks to clear. Send a cashier's check or a money order for faster turn-around time. Make all payments payable to CleavOnline.Com. You can also mail us your credit card information if you are worried about using it online as many people are.

Complete All Information, Print Form, Then Mail This Form To:

P-D-T.Com
PO BOX 16764
Rochester, NY  14616

Shipping Information

Name & Shipping Address:
Include complete street address, city, 
state and zip code.

Phone Number:

E-Mail Address:

Credit Card Information (If Paying By Credit/Debit Card)

Visa/MasterCard/Amex/Discover #:

Visa/MasterCard/Amex/Discover Expiration Date:

Product Description + S&H

Instant Clean Add-It-Ive

$50 Each / 2 For $90 + $9.95 S&H Quantity:

Spike Additive

$125 Each / 2 For $230 + 9.95 S&H Quantity:

Sub Solution

$55 Each / 2 For $100 + $9.95 S&H Quantity:

Hair Follicle Shampoo

$60 Each / 2 For $110 + $9.95 S&H Quantity:

Rescue Cleanse 16 oz. Detox Drink (Watermelon Flavor)

$50 Each / 2 For $95 + $9.95 S&H Quantity:

Rescue Cleanse 32 oz. Detox Drink (Cran-Apple Flavor)

$65 Each / 2 For $115 + $9.95 S&H Quantity:

Green Clean "One Shot" Apple Concentrate

$50 Each / 2 For $90 + $9.95 S&H Quantity:

Supreme Klean Mouth Wash (Saliva)

$60 Each / 2 For $100 + $9.95 S&H Quantity:

Oral Clear Gum (Saliva)

$90 Each / 2 For $165 + $9.95 S&H Quantity:

Single Panel Test Kit

$20 Each / 2 For $35 + $9.95 S&H Quantity:

Six Panel Test Kit

$25 Each / 2 For $45 + $9.95 S&H Quantity:

Pre-Cleanse Herbal Formula

$25 Each / 2 For $45 + $9.95 S&H Quantity:

Value Packs

+ $9.95 S&H

Shipping Prices

$14.95 to Upgrade to RUSH S&H
(USA ONLY / 2-3 Days)

$34.95 to Upgrade to OVERNIGHT S&H
(USA ONLY / Next Day)

$50 for NON-USA CUSTOMERS
INTERNATIONAL S&H

Total Cost (USD) Product Cost + S&H Choice

Can't print this form? Write us a note or email your name/address here and we'll send one to you!

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