JUGOS Detox Order Form
Please note: Our juices are made fresh each day without additives or preservatives. We recommend consuming them within 8-12 hours with proper refrigeration. As a result, it requires pick up each morning of your cleanse program. Please submit your order by 4pm the day before your desired start date.

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Email *
Name (First & Last) *
Phone Number *
In case we need to reach you regarding your order
Email Address *
Please provide us with a valid email for your order confirmation
Select Pick Up Location *
Detox Type *
For how many days would you like to do your juice cleanse? *
If you selected a "Custom Detox", please fill in your selection of 6 juices in the box below.
Date of Pick Up - Day 1 *
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Time of Pick Up - Day 1 *
Please note that pick up times begin as follows: Mon-Fri 7:30am; Saturday 9:30am; Sunday 10:30am
Date of Pick Up - Day 2
MM
/
DD
Time of Pick Up - Day 2
Please note that pick up times begin as follows: Mon-Fri 7:30am; Saturday 9:30am; Sunday 10:30am
Date of Pick Up - Day 3
MM
/
DD
Time of Pick Up - Day 3
Please note that pick up times begin as follows: Mon-Fri 7:30am; Saturday 9:30am; Sunday 10:30am
Date of Pick Up - Day 4
MM
/
DD
Time of Pick Up - Day 4
Please note that pick up times begin as follows: Mon-Fri 7:30am; Saturday 9:30am; Sunday 10:30am
Date of Pick Up - Day 5
MM
/
DD
Time of Pick Up - Day 5
Please note that pick up times begin as follows: Mon-Fri 7:30am; Saturday 9:30am; Sunday 10:30am
Special Requests
Please let us know if you have any special requests or customizations
How did you hear about the juice cleanse? *
A copy of your responses will be emailed to the address you provided.
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