Direct Response Marketing (Jersey) Limited, jersey, channel islands. Mail Order Online Pharmacy.
Viagra, Propecia, Cialis, Uprima, Xenical, Avodart, Regaine (Minoxidil). Treatments for impotence, hair loss and weight loss.  
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 All major Credit Cards accepted
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Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
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Viagra, Propecia, Cialis, British Online Pharmacy. Viagra online ordering.
48 HOUR DELIVERY - ALL PRESCRIPTION PRODUCTS - UK MAINLAND (NOT INCLUDING HOLIDAYS/WEEKENDS)
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Product information

If you have any problems, please Email DRM to let us know.
This is a secure online order form that uses server encryption to protect your personal data.

ACICLOVIR (Zovirax) - MEDICAL DECLARATION

Please complete all the following fields;
(Fields marked IN RED (*) are mandatory)

ORDER FORM

ACICLOVIR

      Despatch Address

      (NOTE; If your credit card billing address is not the same as the despatch address, please enter this below)

      *
      *
      County / Area

      Country
      *
      Post Code
      *
      Credit Card Billing Address
      (if different from the despatch address)
      House Name or number
      Town/City
      Post Code/ZIP
      FAX NUMBER

      DAYTIME TEL NO
      * Please note that this is now required.

      *


      Please give a number that we can contact you on between 9AM and 5PM (UK time).
      PLEASE SUPPLY;-

      *

       

        PLEASE SELECT POSTAGE;

      ALL PRICES ARE IN U.K POUNDS STERLING (£) AND INCLUDE UK POSTAGE PACKING AND ALL FEES.

    Goods are despatched tax-free in the EU, but DRM cannot be responsible for local taxes or import restrictions which may apply in other countries.

      Please debit my credit card.

      *

      Please enter 'XXXX' if any field is left blank after entering your number
      We accept; Visa, MasterCard, Maestro, Delta, Switch, Solo and Electron.
      Card Type
      *
      Start Date
      Expiry Date
      *
      Switch issue number (if applicable)
      Credit Card Security ID number (This is now mandatory):
      *
      Please note that in an effort to reduce fraud and to safeguard the customer it is now necessary to supply the Security ID for Credit Card transactions. If your card does not have a Security ID or you are unable to read it, please contact us. Click the link below for an image of the location of the Security ID on your card.
      Visa/Mastercard - Security ID is printed on the signature strip on the back of the card.
      Name (as it appears on card)

      *

      Please acknowledge;-
      I am aware that my order will be charged in £ (GB Pounds sterling) and the exchange rate will be determined on the day of transaction

      *

      Please enter your name and email address here, so that we can contact you.
      Our doctor requires that we send you an email following receipt of your order to follow up on any potential issues. Entering your email address here, signifies your consent to this.

      Name *

      Email *

      e.g. 'name@domain.com'

      Have you ordered via drm before?
      *
      (This will help us to process your order more efficiently)

    You already know that DRM never share our customer's details with any other company or organisation.
    Neither do we send out regular emails purely for marketing purposes, but we are required to send you an email to follow up on your treatment. We may very occasionally, send our customers updated information regarding a product, or when a new treatment becomes available.
    If you do not wish to receive these emails, please indicate by clicking this box;
    Please check that you have answered ALL the questions.

    Some browsers will not retain the form data and you may need to complete the form again.

    The order may take a few moments to process.

    Please press the button below only once and wait for the acknowledgement page. Thanks.


    This is a secure online order form that uses server encryption to protect your personal data.

    Direct Response Marketing (Jersey) Limited.

    Suite 15 Burlington House, St Saviours Road, St Helier, Jersey, British Channel Islands. JE2 4LA
    Telephone; 0845 121 6667 (UK local rate)
    Fax; 0845 121 6669 (UK local rate)
    International Telephone (44) 1534 510271

    General Enquiries - email: Email DRM: Order Enquiries - email: Email order dept
    All trademarks are acknowledged as the property of their respective owners.

    DRMORDER.JE