This form must be completely filled
out to place an order. We will email a receipt
for all orders placed during our
office hours. IF YOU DO NOT RECEIVE A RESPONSE TO YOUR REQUEST WITHIN AN HOUR OF SENDING IT PLEASE CALL THE OFFICE IMMEDIATELY.
Orders that are received after office hours will
not normally be delivered before 11AM. You must
phone us to verify Same-Day orders. Same day orders cannot be filled if placed after 3PM!!!
Our
analyses are also available in color via
electronic mail and now are also downloadable on the web. You can also view samples on our web site here. If you would like to receive a sample of a specific area directly from our office, please phone us or send us an email. Please download a sample analysis BEFORE you will be receiving your actual analysis to make sure you can print the one you receive.
Please
provide the following ordering information - if your card
is already
on file, you do not need to complete the form, just select
"card on file already" below. If your card is not on file, please call the office as soon as possible with your credit card number as it must be verified before the order is entered.
Credit
card
(Click on window for more options)
Cardholder
name
Card
number
Please call office with credit card number if not on file. Please make sure you submit the form first and then wait 10 minutes to call us to ensure we have received your order.
Billing Address
City
State
Billing Zip
Information
on file
(check this box, if we have your credit card information
on file)
If
this form is NOT working please call our office
at 1-800-677-7633
Apr 05-Apr 30: M-F 9:00AM - 6:00PM
Sat. hours determined by demand by Wednesday 5:00PM
May 03-Sep 11: M-F 9:00AM - 9:00PM
Sat 9:00AM - 5:00PM (sometimes earlier - PLEASE order by 12:00PM)
Sep 13-Oct 01: M-F 9:00AM - 6:00PM
Sat. hours determined by demand by Wednesday 5:00PM
Oct 04-Dec 31: M-F 9:00AM - 5:00PM
Holiday hours to be announced (so please call office). We will be closed: New Year's Day - January 01; Memorial Day - May 31; Independence Day - July 05; Labor Day - September 06; Thanksgiving - November 25-26; and Christmas - December 25
60 Westover Drive - West Melbourne, FL 32904
Office 321-723-5759 or 800-677-7633
Email
Internet: www.roffs.com