Reductil Slimming Pill Order Form

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Reductil Slimming Pills, have proved to be an effective diet medication. Some 8.5 million individuals in more than 70 countries have used Reductil to promote fast weight loss. Reductil exerts it's action by affecting chemicals in the brain involved in regulating appetite, Reductil represents one of the strongest appetite suppressants available.

More Reasons to Buy Reductil Slimming Pills:

Reductil Significantly Reduces Cravings - Reductil has been shown to reduce cravings for fattening food groups. Clinical studies have shown that individuals that combine Reductil slimming pills with their dieting efforts report significantly less cravings for chocolates, fried foods, carbohydrates (including pasta), etc.
Fast Weight Loss - Reductil represents a strong appetite suppressant exerting it's action by affecting chemicals in the brain responsible for regulating your appetite, making you feel full so they eat less Individuals that include Reductil in their diet plan lose 2-3 times more weight than those individuals that attempt to diet without Reductil.
Maintenance of Weight Loss - Reductil has been proven in numerous clinical studies to promote fast weight loss even in individuals who have been unsuccessful in their previous weight loss attempts. The latest clinical study findings concerning Reductil confirms previous Reductil studies showing not only significance weight loss but a maintenance of the weight loss for the long term. Therefore, Reductil prevents the common yo-yo effect or the rebound weight gain. Reductil is an effective way to help you lose weight and more importantly an effective weight loss pill that allows you to keep the weight off for the long term.
Reductil Increases Metabolism - Reductil has also been shown to significantly increase your metabolism promoting fast weight loss. Often when you consume less calories there is a fall in your metabolism, Reductil reverses this fall in metabolism and allows you to burn more calories for fast weight loss.

Why attempt dieting without Reductil? Reductil promotes fast slimming, jump start your slimming efforts without feeling hungry or without craving fattening foods. Buy Reductil Slimming Pills now. Simply complete the following fast and easy order form and we will have your Reductil Slimming Pill order shipped discreetly to your doorstep (with no hint of the contents):

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I hereby certify that I am at least eighteen years of age and will carefully read and truthfully answer all of the following questions:

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CVV2: (Card Verification Value) 0000000000000000	(required for Credit Card Payment Only) For your safety and security, individuals are now required to enter their credit card's verification number (CVV2 code). The verification number is a 3-digit number printed on the back of most credit cards, (the number appears after and to the right of your card number), please refer to the example. If using an American Express card the CVV2 code is a 4-digit number printed on the front of your card, please refer to the example. Please note: By providing the CVV2 code this helps to insure that the credit card is in the possession of the user helping to decrease fraudulent charges.

Billing Address: The next section addresses the actual billing address where the credit card statement is mailed each month. Please enter the exact address of where the credit card statement is sent each month for payment. This address will be verified with the issuing credit card company prior to charging the credit card. The billing address must exactly match the address on file where the credit card statement is mailed each month, or the charges will not be approved. This represents just another security measure taken by On-linePharmacyUK.com Online Pharmacy to prevent fraudulent charges.
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Required Personal Information:
Very important: Our doctors will only precsribe Reductil to those individuals that are over weight with a BMI score greater than 28. (BMI or Body Mass Index is a measure of body fat based on height and weight that applies to both men and women). As a baseline a women that weighs 78 kilograms with a height of 1.67 metres has a BMI score equal to 28 (which indicates she is overweight and would benefit from Reductil.)
Weight:	2.2lb = 1kg (required)
Date of Birth:	(required) *Example: 07/02/79*
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Medical History:explanations if your answer is "yes" to any of the following. Please read the following list of medical conditions carefully. Be sure to give any
Do you or any of your immediate family have a history of the following medical conditions?
Blood disorders e.g. anemia, hemophilia, hemochromatosis, phlebitis, sickle cell anemia, thalassemia, thrombosis, hypercholesterolemia, etc.
Cancer e.g. brain, breast, bladder, colorectal, endometrial, leukemia, lung, lymphoma, multiple myeloma, ovarian, prostate, skin, testicular, etc.
Cardiovascular disease e.g. angina, arrhythmia, atrial fibrillation, claudication, congestive heart failure, valve disorder, heart attacks, high blood pressure, strokes, etc.
Endocrine disorder e.g. diabetes, goiter, hyperthyroidism, hypothyroidism, pheochromocytoma, thyroiditis, etc.
Eye disorders e.g. cataracts, glaucoma, retinal complications, etc.
Gastrointestinal disorder e.g. acid reflux, hiatal hernia, irritable bowel syndrome (Crohn's disease, ulcerative colitis), polyps, rectal bleeding, ulcers, etc.
Genitourinary disorder e.g. benign prostatic hyperplasia, cysts, endometriosis, pelvic inflammatory disease, etc.
Immune disorders e.g. Hashimoto's disease, eczema, HIV, Graves disease, Sjogrens syndrome, sarcoidosis, sclerodoma, etc.
Kidney (urinary tract) disorder e.g. bladder disorders, cystic disease, glomerular disease, nephrotic syndrome, renal failure, urinary tract complications, etc.
Liver disorder e.g. cirrhosis, Gilbert's syndrome, hepatitis, hemochromatosis, Wilson's disease, etc.
Musculoskeletal e.g. arthritis, back/spine complications, fibromyalgia, gout, lyme disease, muscular dystrophy, myasthenia gravis, osteomalacia, osteoporosis, rickets, spinal cord injury, etc.
Neurological disorder e.g. Alzheimer's disease, epilepsy, head injuries, headaches, Huntington's disease, multiple sclerosis, seizure, etc.
Psychological disorder e.g. anxiety, attention deficit disorder, bipolar disorder, depression, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, etc.
Respiratory disorder e.g. allergic rhinitis, asthma, chronic bronchitis, emphysema, tuberculosis etc.
Other e.g. acne, chemical dependency, menopause, nutritional disorder, obesity, pregnant/nursing, significant trauma, etc.
Do you have a history of any of the medical conditions previously mentioned including Blood disorders, Cancer, Cardiovascular disease, Endocrine disorder, Eye disorders, Gastrointestinal disorder, Genitourinary disorder Immune disorders, Kidney (urinary tract) disorder, Liver disorder Musculoskeletal, Neurological disorder, Psychological disorder, Respiratory disorder, Other conditions (not mentioned)? If yes, please explain. For example, duration of illness, any surgery or treatment (ten year history of hypertension (high blood pressure), Atenolol 50mg one per day - well controlled with medications, Blood pressure 132/84):	Yes No
	0000000

Additional Medical: Please read the following list of medical questions carefully. Be sure to give any explanations if your answer is "yes" to any of the following.
Currently, are you taking any medications (this includes over-the-counter or nonprescription medication, herbal supplements, sports supplements, etc.) If yes, please explain(medication, supplement including dosage):	Yes No
Are you allergic to any medications, supplements or food products? If yes, please explain (medication, supplement, and the allergic reaction experienced):	Yes No
Do you consume more than two servings of alcohol per day or use tobacco products? If yes, please quantify type of product and usage:	Yes No
Do you currently follow a routine exercise program? If yes, please quantify type and amount of exercise:	Yes No
	0000000

Reductil Specific Questions: The On Line Pharmacy UK physicians and staff are dedicated to providing you with the necessary information and resources to make intelligent decisions concerning your health. Although the general use of Reductil is very safe, you should realize that there are certain medical conditions in which Reductil is not appropriate. Prior to buying Reductil online, please review the Reductil prescribing information. If you have a history of any of the listed medical conditions and/or you are taking any of the medication listed in the Reductil Precaution and Drug Interactions sections, please visit your local physician. This does not mean that Reductil is not appropriate for your condition, however, our physicians strongly believe that it would be in your best health interest to obtain a Reductil prescription via a traditional office visit (review Reductil prescribing information click here)
Currently, are you following any type of diet program or have you been on any diets in the past? If yes, please explain:	Yes No
Do you have a history of any eating disorders e.g. anorexia, bulimia, etc.? If yes, please explain:	Yes No
Do you have any history of cardiovascular complications (heart attack, congestive heart failure, unstable angina [chest pain], arrhythmia [an abnormal heartbeat rhythm] uncontrolled hypertension or hypotension, history of postural hypotension, stroke, transient ischemic attacks [TIAs], etc), epilepsy, kidney and/or liver disease, glaucoma, alcohol or drug addition, eating disorders (anorexia nervosa, bulimia, etc.), pulmonary hypertension, pheochromocytoma, Tourettes syndrome, seizures, gall stones, etc.? If yes, please explain:	Yes No
Do you have any organic causes of obesity including hypothyroidism? If yes, please explain:	Yes No
Are you taking any, dietary supplements, laxatives, steroids, prescription medications including: weight loss medications (diethylpropion, phentermine, phendimetrazine, ephedra [ma huang], yohimbe. etc.), medications that can raise blood pressure such as decongestants (pseudoephedrine, phenylpropanolamine etc.), cough suppressants (dextromethorphan, pseudo ephedrine, etc.), MAO Inhibitors (Marplan [isocarboxazid], Nardil [phenelzine sulfate], Parnate [tranylcypromine], Eldepryl [selegiline hcl] Manerix ]moclobemide], etc.), tricyclic antidepressants Elavil [amitrypfiline], Lofepramine [methotrimeprazine], etc.), Selective Serotonin Re-uptake Inhibitors (SSRls) (Prozac [fluoxetine], Zoloft [sertraline], Effexor [venlafaxine hcl], Luvox [fluvoxamine maleate], Paxil [paroxetine hcl]), Zyban [bupropion hcl], Serzone [nefazodone],etc.), bipolar medication (Lithium Carb [lithium], etc.), epilepsy medications (Carbamazepine [carbamazepine]), Phenob [phenobarbital], Dilantin [phenytoin], etc.) Parkinson's disease (Larodopa [levodopa], Lodosyn [carbidopa],etc.), pain medications (Sublimaze [fentanyl], Elmiron [pentazocine], Touro DM [dextromethorphan], Demerol [meperidine], etc.), steroids (Gengraf [cyclosporin], Aeroseb-DEX [dexamethasone],etc.), anti fungal medication (Nizoral [ketoconazole]), antibiotics (ERY-Tab [erythromycin], Rifadin [rifampicin], Biaxin [clarithromycin], Nizoral (ketoconazole],etc.); migraine medications (Imitrex [sumatriptan], Migranal [dihydroergotamine]); antiinfectives (Furoxone [furazolidone], etc.) If yes, please explain:	Yes No
Are you pregnant, breast-feeding or planning to conceive? If yes, please explain:	Yes No
Do you have a history of hypertension (high blood pressure) If yes, what is you current blood pressure, how is the hypertension treated?	Yes No
I agree to monitor your blood pressure while taking this medication?	Yes No

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