Yes, I want to order copies of the HEALTH MENTOR™ Health Risk Assessment for Men
	Unfortunately, individual copies of HEALTH MENTOR™ are not available for sale. However, we encourage you to ask your employer or health care provider to make HEALTH MENTOR™ available to you and your male peers

	Select number of copies	PLEASE SELECT THE NUMBER OF COPIES YOU WISH TO ORDER 100 copies @ $.95 each--$95.00-minimum order 200 copies @ $.90 each--$180.00 300 copies @ $.85 each--$255.00 400 copies @ $.80 each--$320.00 500 copies @ $.75 each--$375.00
	Select postage option	SELECT POSTAGE OPTION HERE Shipping within the United States--$8.00 Shipping outside the United States--$16.00
	Total (in U.S. funds)	PLEASE ENTER THE TOTAL AMOUNT HERE
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	Check or money order	Please make check or money order to Men's Health Consulting Tax ID# 556927933

	To order by phone, call 510-649-0550 or 1-800-WELL MEN 2811 College Avenue, Suite 1, Berkeley, CA 94705-2167 USA For comments and questions, please contact us at info@menshealth.org
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