Healing Waters
Secure Order Form


You may complete this form and submit your order online via our secure server, or you may order from Canada or the U.S. by phone toll free at 877-455-8859, direct dial from outside Canada or the U.S. at 505-243-5804, or by fax at 509-356-0535 .  For best service by phone, please prepare by printing and completing this form before calling. 

With any method, your Visa, MasterCard, E-check, or check by phone are welcome!  If you prefer to pay by money order or International Postal Money Order, please do not use this automated form, but use email or fax instead.  Payment must be in U.S. dollars.  Please use the following link if you need information about currency conversion: The Universal Currency Converter(tm)

If you prefer to use PayPal, DO NOT use this order form!  Pay through your PayPal account.  Click on the Send Money tab and use the email "mindymae@earthlink.net" (no quotes).  You may itemize your purchase through the PayPal email window at time of payment, or provide your order by email, fax, or phone call.

If you are a repeat customer and none of your address or billing information has changed, you do not need to fill out the form.  We can process your order for you if you send us an email or voicemail.

Please email or call us before submitting order if you have any questions, 
want to specify shipping other than USPS Priority or international airmail, or want to review your invoice before billing.

Are any of your items on the Sale page?  If so, please remember to adjust the price on the Order Form! 

  Sale Page. Price List.

PRODUCT INFORMATION (If ordering more than 15 items, please email us or give us a call toll free at 1-877-455-8859, or fax your order to 509-356-0535.)

If we are out of a size requested, may we substitute a larger or smaller size? (We will adjust your total and issue a credit if appropriate.  Checking "Yes" to substitution is automatic authorization to charge your card for the legitimate amount incurred by a substitution.)

If we don't have an essence from a brand requested, may we substitute the same essence from a different brand?

Do you want your order held until complete if items are on backorder?  We WILL notify you as soon as we know an item is on backorder.  (In most cases, additional postage will be NOT charged for orders split into more than one shipment and will be mailed regular mail.)

Is this order a gift?   (If so, please tell us on a line on the form if you want a lovely personalized certificate to be included in the shipment and/or the invoice sent to you instead of to your friend.)


SAVINGS CHOICES for USA Customers only
(non-USA customers may use either your discount or current sale price, if any--sorry, no free shipping)

You may choose ONE of the following to save money:

I am using my referral or other preapproved discount on this order.  (please deduct amount)

I want FREE SHIPPING for my order of more than $150.  (please leave shipping line blank)

I want the current sale discounts and have adjusted my price accordingly.  (please deduct amount)



This is to ensure that discounts are not combined.  If you choose more than one, we will need to contact you before shipping your order to confirm one choice.  And if you do overpay, we will credit your card or give you equivalent store credit.
NOTE: Please DO NOT enter dollar signs ($) into the form below.
Qty. Size Product Description Brand Name  Each
USA and Canada
Packing and Shipping Rates
(all USA orders sent USPS Priority)
$0.00 - $30.00 $4.50
$30.01 - $70.00 $6.50
$70.01 - $125.00 $8.50
$75.01 - $150.00 $10.00
$150.01 +
Free in U.S.
(if not using any other discount)
Actual postage will be due for 
books or large orders for empty bottles.
Using the Order Form constitutes permission for Healing Waters to bill any actual shipping charges that may be due.

Shipping charges are based on pre-discount prices because shipping weight does not change when a sales price goes down. 

Enter shipping amount here: $
Check this box if you are a New Mexico Resident

For "Shipping," use the applicable 
handling charge from the following chart.
We will bill your Visa or MasterCard separately for
actual postage after mailing. 

Overseas Orders:
Handling Charge
$0.00 - $100.00 $2.50
$100.01 - $300.00 $5.00
$300.01 - $500.00
$500.01 - $1,000.00
more than $1,000.01

We ship airmail to locations outside the U.S. unless you request surface mail.  Typically, airmail takes 7 to 10 days to arrive, depending on service in both countries.  Surface mail can take 4 to 6 weeks to arrive and we will not use that unless you request it. 

If you have an urgent order, please call1-877-455-8859 or email first to verify
your items are in stock.   In-stock items can be sent the same day (even most 
Saturdays and Sundays) IF the order is verified by us before 5:00 PM Mountain Time USA. 
This section is optional.
How did you hear about us?

Please identify the Name, List Name, BBS, Group, URL, etc., for who referred you

Refer a friend! If your friend makes a purchase and tells us you sent them, YOU get 10% off your next order!  It's easy!  We will send you and your friend a confirmation of this offer. (The below is only to verify sources...we will not contact your friend first.)
Who would you like to refer? 
First/Last Name: 
Please notify me by email about upcoming specials, sales, new products, etc.
Yes, please notify me. 
No, please do not notify me. 
Payment Method: Credit Card (Visa/MasterCard)
Checking Account (Drawn on a U.S. bank only)
Payment by Money Order and International Postal Money Order in USD must be approved in advance by email or telephone.

 Sorry, no COD.

Credit Card Information (If Payment method is Credit Card)
Card Number:
Exp. Date:
Checking Account Information (If Payment method is Checking Account) 
Bank Name:
Account Number:
(enter numerals only--no dashes or spaces)
ABA Routing Code:
(Click here for help) 

First Name:
Last Name:
(As it appears on your credit card statement.)
ZIP/Postal Code:
(Include area code) 

SHIPPING INFORMATION (Please include only if different from above.)
First Name:
Last Name: 
Zip/Postal Code: