Symbiotic Systems, Inc.
Secure Server On-line Order Form
Sorry folks, but we are no longer selling Lice Rx due to corportate greed. Since the corporations couldn't patent our product, they had your government make it illegal so, enjoy head lice America. After 15 years we can no longer help you. Sorry.
Your transaction will be 100% secure. All information provided will pass through our RSA Approved SECURED SERVER. To pay on-line right now using our 100% secured server, simply fill in the following sections of this form. Use the tab to move from field to field until you reach the multi-selections and then click on the box to highlight your choice. Your e-mail address is important so that we can send you a confirmation of shipping.
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1997/8/9/2000/2001/2002/2003 Symbiotic Systems, Inc.
Most recent revision Wednesday, October 8, 2003