Institute for Functional Health

Your Phone Number (required)

Card Number (required)

Card Expiry (required)

CVV number (required)

Amount To Charge** (required)

I hereby authorise the Institute For Functional Health to charge the above credit/debit card for the amount specified

*Please note that final charged amount may differ marginally due to fluctuations in foreign exchange currency rates
** Please use the table below to calculate the amount to charge (eg. a single order of 5 units is NZD$150 x 5 units + NZD$45 delivery charge = NZD$195). Any inconsistencies may result in delays.