Order Form

Order form

Lifestyle Institution LLC
3682 North 230 East,
Provo,
Utah, 84604.
801 434 5467

If you do not wish to order thru the Shopping Cart, please complete this electronic Order Form which will be e-mailed to our office. Upon receipt, we will calculate your order and advise you the total amount by return e-mail. Once you receive and accept our calculation, you may mail a check or money order to the above address. Upon receipt of your payment at our office, your order will be mailed as per your shipping instruction.

YOUR NAME AND SHIPPING ADDRESS:

Name:

Address:

City:

State:

Zip Code:

YOUR CONTACT INFORMATION:

E-mail address:

Telephone (Home):

Telephone (Business):

Cellular Phone:

Cellular Phone:

State of Utah only: Sales Tax @ 6.25% will be added to your order

Select your shipping preference.
Shipping includes Delivery Confirmation and is calculated as follows:

Please put the number of item(s) you would like to order in the box next to the name of the item.

CREAMS:
ANTI-WRINKLE DAY & NIGHT MOISTURIZER (Mature skin) 50ml cream $25
ANTI-WRINKLE DAY & NIGHT MOISTURIZER (Pregnant woman) 50ml cream $25
ANTI-WRINKLE AFTERSHAVE (Face cream for men) 50ml cream $25
YOUTH DEW DAY & NIGHT MOISTURIZER (for younger skin) 50ml cream $25
SKIN RELIEVER for ECZEMA and PSORIASIS 50ml cream $25
HAND CREAM SPECIAL OFFER 50ml cream $15
HAND CREAM (Pregnant woman) SPECIAL OFFER 50ml cream $15
CRACKED HEELS RELIEVER 50ml cream $15
CHILDREN: DEAN’S BODY LOTION (for boys) 12oz lotion $15
CHILDREN: REMY’S BODY LOTION (for girls) 12oz lotion $15
BABIES: CONNOR’S BABY LOTION (for boys and girls) 12oz lotion $15
BABIES: KELSEY’S DIAPER RASH CREAM (for boys and girls) 50ml cream $15

EXFOLIATION CREAMS:
EXFOLIATION CREAM (Face) 50ml cream $15
EXFOLIATION CREAM (Hands & Body) 50ml cream $15
EXFOLIATION CREAM (Feet) 50ml cream $15

BODY LOTIONS:
BODY LOTION: FLORAL (Relaxation and skin regenerator) 12oz lotion $15
BODY LOTION: CITRUS (Relaxation, detoxification and skin rejuvenator) 12oz lotion $15
BODY LOTION: SPICES (Muscular aches and pains) 12oz lotion $15
BODY LOTION: HERBAL (Mental upliftment) 12oz lotion $15
BODY LOTION: REGULAR (Relaxation, upliftment, cell detoxification and regeneration) 12oz lotion $15

BATH OILS:
BATH OIL: FLORAL (Relaxation and skin regenerator) 200ml oil $15
BATH OIL: CITRUS (Relaxation, detoxification and skin rejuvenator) 200ml oil $15
BATH OIL: SPICES (Muscular aches and pains) 200ml oil $15
BATH OIL: HERBAL (Mental upliftment) 200ml oil $15
BATH OIL: REGULAR (Relaxation, upliftment, cell detoxification and regeneration) 200ml oil $15

ASTRINGENTS & SKIN TONERS:
FACE TONER (for women) 200ml oil $15
AFTERSHAVE ASTRINGENT (for men) 200ml oil $15

DEODORANTS:
DEODORANT (Feminine) 30ml / 1oz $10
DEODORANT (Masculine) 30ml / 1oz $10
DEODORANT (Pregnant woman) 30ml / 1oz $10

PREGNANT WOMEN'S CREAMS, OILS AND LOTIONS:
ANTI-WRINKLE DAY & NIGHT MOISTURIZER (Pregnant women) 50ml cream $25
HAND CREAM (Pregnant women) 50ml cream $15
BODY LOTION: CITRUS (Relaxation, detoxification and skin rejuvenator) 12oz lotion $15
BATH OIL: CITRUS (Relaxation, detoxification and skin rejuvenator) 200ml oil $15
STRETCH MARKS RELIEVER (Pregnant women) 30ml / 1oz oil $15
DEODORANT (Pregnant woman) 30ml / 1oz $10

BABY OILS AND LOTIONS:
BABIES: KELSEY’S DIAPER RASH CREAM (for boys and girls) 50ml cream $15
BABIES: CONNOR’S BABY LOTION (for boys and girls) 12oz lotion $15
BABIES: TAYLA’S BATH OIL (for boys and girls) 200ml oil $15

CHILDREN'S OILS AND LOTIONS:
CHILDREN: DEAN’S CREAM (for boys) 12oz lotion $15
CHILDREN: REMY’S BODY LOTION (for girls) 12oz lotion $15
CHILDREN: NICK’S BATH OIL (for boys and girls) 200ml oil $15
CHILDREN: SCOTT’S ALL PURPOSE RELIEF OIL (for boys and girls) 30ml / 1oz oil $15

THERAPEUTIC & AROMATIC ROOM SPRAY:
FRENCH LAVENDER 12oz $15

PERFUMES:
JUANIQUE AROMATIQUE ROLL-ON SKIN PERFUME (oil based) 1/3 oz $10
PRISCILLA SPRAY PERFUME (alcohol based) SPECIAL OFFER 2 oz $25

THERAPEUTIC OIL BLENDS:
ALL PURPOSE RELIEVER (Adults and children) 30ml / 1oz oil $15
BRUISE RELIEVER 30ml / 1oz oil $15
BURNS and SUNBURN RELIEVER 30ml / 1oz oil $15
CAPILLARY SUPPORT 30ml / 1oz oil $15
CELLULITE RELIEVER 30ml / 1oz oil $15
CIRCULATORY SUPPORT (for cold hands and feet) 30ml / 1oz oil $15
COUGH RELIEVER 30ml / 1oz oil $15
DETOXIFICATION and SLIMMING 30ml / 1oz oil $15
FATIGUE RELIEVER (Physical) 30ml / 1oz oil $15
FATIGUE RELIEVER (Mental) 30ml / 1oz oil $15
FLUID RELIEVER (for fluid retention) 30ml / 1oz oil $15
FUNGAL RELIEVER 30ml / 1oz oil $15
HEADACHES and MIGRAINE RELIEVER 30ml / 1oz oil $15
IMMUNE SUPPORT 30ml / 1oz oil $15
INFLAMMATION RELIEVER (for muscle aches and general pains) 30ml / 1oz oil $15
INSECT BITES, STINGS and REPELLENT 30ml / 1oz oil $15
JOINT SUPPORT (for joint and Arthritic discomfort) 30ml / 1oz oil $15
NAIL STRENGTHENER 30ml / 1oz oil $15
PMS and MENSTRUAL CRAMPS RELIEVER 30ml / 1oz oil $15
RELAXATION SUPPORT 30ml / 1oz oil $25
RESPIRATORY SUPPORT (for Asthma, influenza, bronchitis, pneumonia) 30ml / 1oz oil $15
SCAR and CELL REGENERATOR 30ml / 1oz oil $15
SLEEP SUPPORT 30ml / 1oz oil $15
STRETCH MARKS RELIEVER 30ml / 1oz oil $15
STRETCH MARKS RELIEVER (Pregnant woman) 30ml / 1oz oil $15
UPPER RESPIRATORY RELIEVER (for sinus and nasal congestion) 30ml / 1oz oil $15
VEIN SUPPORT 30ml / 1oz oil $15

BOOKS
YOU ARE WHAT YOU EAT $15
AROMATHERAPY FOR NATURAL HEALTH AND BEAUTY $25