Schedule an Appointment with Gay Riley - Nutritionist, Dietitian, & Personal Trainer Specializing in Medical Nutrition Therapy & Health and Fitness.

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If you are seeking Medical Nutrition Therapy, include name of physician and the phone/fax number:

What service are you interested in?

Netnutritionist Startup Consultation (details...)	$250
Startup Consultation and 3 months bodybugg™ website only (details...)	$375
Basic bodybugg® Package (details...) Basic bodybugg® Package regular price $495 Special until March 5, 2008	$335
Basic bodybugg® Package+Digital Display (details...) Regular price $550 Special until March 5, 2008	$399
The Bodybugg Digital Display (details...) (must be used with bodybugg®)	$99
Phone Consultation ($75 for every 30 minutes)	$75


Subtotal	75.00
Shipping	0.0
Tax	0.0
Total	$75.00
($15.00 shipping for bodybugg™ orders.)

If you wish to pay by check or money order, please print this form and mail with your payment. (NOTE: You will need Adobe Acrobat Reader to download this form. This free program is available to download at www.adobe.com.)

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