Fax your order through to Cellumend - the treatment which people claim is the only real cellulite cure.

Fax ordering

Kindly complete the form in black pen to ensure that the fax comes out clearly, and fax it through to Dermaxime, our holding company at 00 27 12 361 0061. (The South African dialing code is 27)

Type of credit card - tick box			Visa	MasterCard		Amex	Diners
Expiry date of card		Year Month
Your Name & Surname (As printed on the card)
Credit card number
CVV number (the last three numbers printed on the back of your card - normally on the signature strip)
e-mail address
Shipping address

City
State/Province
Zip code & Country
Telephone #		( )
Skincare and grooming Items	1.	Cellumend			US $
	2.				US $
	3.				US $
	4.				US $
	5.				US $
	6.				US $
		TOTAL			US $
Special instructions
Your signature

Information supplied is for general information purposes only and no statements have not been evaluated by the FDA or the S. A. MCC and no information supplied is intended to diagnose, treat, cure or prevent any disease.

© Copyright Dermaxime (Pty) Ltd 2001 - 2010. The entire content of this website is copyrighted - including text, photographs, logos, metatags etc., and no part whatsoever may be copied and used - privately, for educational purposes or publishing or for commercial application - without the written permission of Dermaxime (Pty) Ltd. Cellumend™ Our site is maintained and was last updated on 4 March 2010.