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City.....:_____________________________ Phone: ______________

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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 Pill Box EZ Program Medication Reminder ($49.95 complete w/ batteries)

_____ e-pill CADEX VibraPlus Vibrating 8 Alarm Watch with Leather band ($99.95 Color: __ Black & Silver / black band)

_____ e-pill Med-Time XL Reminder & Automatic Dispenser complete ($389.95 w/batteries, 2 medication trays lock w/ key (2), prescription card, manual)

_____ 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 ($139.95 /rubber strap. Color: __ Silver __ Black)

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

_____ Mass residents please add 6.25% sales tax.

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

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

e-pill, LLC | d.b.a
49 Walnut Street, Bldg. 4
Wellesley, MA 02481, USA
Fax: (781) 235-3252
Shipping & Handling: FREE Standard Shipping (Outside US $15.00/order)

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©Copyright e-pill, LLC 2002-2017, 2018 Med-Clock™, MEDClock™, e-pill®, ePill®, CADEX®, Accutab®, PuffMinder®, HIProtector® are trade and service marks, reach us at or or (800) 549-0095 or (781) 239-2941. We accept: AMEX, VISA, MasterCard, Discover and Paypal.

e-pill is the leading provider of Electronic Medication Reminders

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