Delivery Booking Form:
Email address *
What Type of delivery are we doing today? *
What Place(s) are we picking up from today? *
For two or more stops, We charge $5 for each additional stop AFTER the first one.
Your answer
Place Your Order Here. *
Restaurant orders, Grocery lists, prescription information or other items we are to pick up.
Your answer
Are substitutions allowed? *
If you choose to have us call you if we have questions concerning your order, YOU MUST ANSWER YOUR PHONE WHEN WE CALL. If our attempts to call are ignored or you're not available, we will either choose for you or immediately cancel the order before completing and you will have to resubmit the order at a later time when you will be available.
When are we delivering this order? *
(today, tomorrow, asap, specific date, etc.))
Your answer
Name for the Order? *
Your answer
Address We Are Delivering To? *
Your answer
City? *
Orders delivered or picked up outside Medford are charged a mileage fee of $1.25 per mile to the actual address.
Your answer
Phone Number *
Orders will NOT be processed without a working phone number. To avoid delays or cancellation of your order, be by your phone in case we have to contact you.
Your answer
How will you be paying for this order? *
Large orders ($100 & over) require card payment information in advance. Sorry, we do not accept checks as payment.(cash payments only, if you're using our "reduced service" option)
How to use PayPal
We require a credit card in advance for all out-of-State orders. For any credit cards that we cannot physically verify with the customer, we may place a “code 10 authorization” request to your card issuer before we do your order. This ensures that the card belongs to the consumer and that we can safely run the card for payment. Doing this may flag your account as suspicious until verified so you may get an alert from your card issuer. You may also have us keep your card on file if you regularly order from us. Unless you specify otherwise, we destroy all card information immediately after use. Make sure you fill out all fields. We may call you for any missing information. You are always welcome to have us take your card information over the phone if you aren't comfortable submitting on line.
Card Number
Your answer
Expiration Date
Your answer
Security Code
3 digit on back of card (4 digit on front of Amer. Ex)
Your answer
Name on card
Your answer
Billing Address
Your answer
Billing Zip Code
Your answer
Preferred Contact Method *
Special Instructions for our Driver?
Location directions, No knocking, hidden driveway, gate code needed, etc.
Your answer
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