Fax Order Form  Canadian Clients

Fax: 1-905-664-7085

Company /Business name:

ZIP / Postal Code:


I would like to order ______ copy of Phases rehab CD ROM @$249.99 US/unit*
I would like to order ______ copy of Dr. S. Yeomans QFCE CD ROM @$49.99 US/unit*
I would like to order the Phases/Yeomans Promotion @$279.99 US*

*Price doesn't  include shipping/ handling or taxes.

 Please note US Funds.

Payment Options:  
Visa    Mastercard              
Credit Card Number # : Expiry Date:

Card Holder : ( Print)  {Plertrtrase        


The authors have made every effort to ensure the accuracy of the information herein, in particular with regard to the protocols and procedures of the specific exercises. No patient, however, should perform any of these exercises without proper instruction from their doctor or therapist. The authors disclaim any responsibility for any adverse effects resulting directly or indirectly from the suggested exercises, undetected errors, or the reader's misunderstanding of this text.

Signature / date