A Healing Advantage ~ Order tape

Tailored
Just for you!

$ 39.⁹⁵

plus taxes
& shipping

Order the tape or CD

Side A: Dealing with stress
Side B: Creating new habits tailored to your needs

You will be emailed through PAYPAL for payment.

in Ontario
8% PST
$3.20

In Canada
7% GST
$2.80

Email	:
double check your info for accuracy
Name	:
Address	:
City	:
Prov / State	:
Country	:
Postal code	:
Phone	:
Ship by	:	tape or CD

the name my family or friends call me

Chose one :

Don't tell me what to do!
I like being told what to do

A safe place to me would be

near meadow woods trees creek lake waterfall no water	or in a garden with fountain flowers birds butterflies grass	or on a hill mountain or in a library trophy room studio describe below

Give a brief description of when and how you started smoking

I am quitting because

I want to
someone else wants me to
whom?
doc wants me to

Check the ones that apply ... I light up

first thing, morning after any meal drink coffee get in the car while driving at work before I arrive	get frustrated get angry get upset need a break need to think need to relax get bored	others light up middle of night automatically chain smoke with friends drink alcohol I toke
any other time?

When I quit I will gain ...check most important 5

better health family health I smell better whiter teeth fresher breath	house won't smell car won't smell my pride family's pride warmer in winter	more money breath easier be a role model work better play sports better
anything else?

Thank you for your order!