Order Request
After you fill out this order request, we will contact you to go over details and availability before the order is completed. If you would like faster service and direct information on current stock and pricing please contact us at +2711 706 2786 or reception@perfecthealthpractice.com.
Email address *
Are you a new or existing customer? *
Have you had the medicines you need prescribed for you previously by Dr Robin Kohler? *
What are the items you would like to order? *
Would you like the items delivered by The Courier Guy at an additional cost, or kept in-store for collection? *
Required
For delivery, please provide the delivery address for the courier.
Contact info
Your name *
Phone number *
E-mail
Questions and comments
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