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Your choice: Order ON-LINE: (via our secure link) by clicking 'ORDER This ITEM' next to the item you want to purchase (do not forget to check-out) or
PRINT and use this ORDER FORM. Call (800) 549-0095 for questions.

30-Day Money Back Guarantee. One Year Warranty.

Name.....:________________________________________________

Address..:________________________________________________

City.....:_____________________________ Phone: ______________

Zip......:__________________State or Country:______________________

Payment by: ___ Check/Money Order enclosed ___ Charge my credit card

___MasterCard ___VISA ___AMEX ___Discover ___Diner's Club

|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

Exp. Date: _________ Signature: _____________________________

Please send me: (We can ship to a different address - please indicate)

_____ e-pill 7-Day Organizer & Reminder WORLD's BEST! ($59.95 canvas case, 7 high capacity organizers, electronic reminder

_____ e-pill Multi-Alarm Easy-to-Program Pocket Medication Reminder ($39.95 complete w/ soft case & batteries)

_____ e-pill Multi-Alarm Pill Box EZ Program Medication Reminder ($49.95 complete w/ batteries)

_____ e-pill MEDGlider Organizer & 4 Alarm Reminder complete ($45.95 Reminder w/batteries, 1 organizer and Tray)

_____ e-pill MeDose Vibrating 6 Alarm Watch with Leather band ($99.95 Color: __ Black & Silver / black band)

_____ e-pill Almeda 6 Alarm Analog (with Face and Hands) Vibrating 6 Alarm Watch with Leather band ($195.00 Color: __ Stainless Steel)

_____ e-pill Med-Time Reminder & Automatic Dispenser complete ($289.95 w/batteries, 2 medication trays lock w/ key (2), prescription card, manual)

_____ e-pill Parkinson's Sipping Bottle. Easy to Hold Sipping bottle for better fluid intake ($4.95 / Green)

_____ e-pill Pager Vibrating Multi-Alarm Reminder (12 Alarms). Carry it in your pocket, purse or on your belt. ($75.95 w/batteries and Belt Clip)

_____ e-pill CADEX Text 12 Alarm Reminder & Medication ID Watch ($79.95 /rubber strap. Color: __ Silver __ Black)

_____ Watch Accessory ($9.95):
__ Pendant kit __ Blue strap __ Red strap __ Diabetes __ Medical Condition __ Brown strap

_____ e-pill Once-A-Day Medication Reminder ($5.95 2 per pack)

_____ e-pill PERS Help-At-Hand Model 911 (No Monthly Fees) PERS system (Special $199.00 complete w cord, AC adapter, manual, main unit, 2 pendants w/ batteries)

_____ e-pill Cube Pillbox Timer up to 24 daily alarms ($24.95 complete w/ batteries)

_____ Mass residents please add 5% sales tax.

_____ Shipping and Handling (FREE Standard Shipping, Outside US $15.00/order)

_____ ORDER TOTAL .... My Time-Zone: ______ (for FREE set-up)

MAIL ORDERS:
e-pill, LLC | d.b.a MEDclock.com
49 Walnut Street, Bldg. 4
Wellesley, MA 02481, USA
http://www.epill.com
FAX ORDERS:
Fax: (781) 235-3252
PHONE ORDERS:
1-800-549-0095
Shipping & Handling: $5.95 per order (Outside US $15.00/order)



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©Copyright e-pill, LLC 2002-2016, 17 Med-Clock™, MEDClock™, e-pill®, ePill®, CADEX®, Accutab®, PuffMinder®, HIProtector® are trade and service marks, reach us at http://www.epill.com or http://www.medclock.com or (800) 549-0095 or (781) 239-2941. We accept: AMEX, VISA, MasterCard, Discover and Paypal.

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e-pill, LLC is not a Medicare Provider and does not bill Medicare. If you are a Medicare recipient you assume complete financial responsibility for your purchases. e-pill®, PuffMinder®, ePill®, HIProtector® are registered trademarks.


e-pill Medication Reminders | www.MEDclock.com
e-pill, LLC | 49 Walnut Street, Bldg. 4 | Wellesley, MA 02481, USA
www.epill.com | 1-800-549-0095 | +1 (781) 239-2941 | fax + 1 (781) 235-3252