Just print this page and fax to 251-625-2612 or mail to LifeStream Medical, 607 Dryer Avenue, Daphne, AL 36526

Please send me__________copies of Anytime...For as Long as You Want:  Strength, Genius, Libido, &  Erection by Integrative Sex Transmutation.  Tape and workbook will be discretely packaged. 

If I am not completely satisfied for any reason, I can return the workbook  and you will completely refund every cent.

Charge  my credit card $24.95 for each copy ordered or cash my check (made out to LifeStream Medical, Inc.).  Shipping is free within the United States (other countries add and additional $14.00).

Ship to:


Street (shipping)_______________________________



Billing information:

Type Card (MC or VISA)

Credit Card Number___________________

Exp. Date___________________________

Telephone (_____) _____-____________

Street address on credit card_______________

State on credit card__________ Zip _________


Email address_________________________   May I send you a  newsletter every 2 weeks about   how to improve your health?  _____ yes   _______ no