Order Form
Please provide the following information for order processing:
Name:____________________________________________________________________
Phone Number:____________________________________________________________
Fax Number:______________________________________________________________
Address:_________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

Shipping Address (if different than above):______________________________
_________________________________________________________________________
_________________________________________________________________________

Check
Check Number:_______________

Our Information:
Phone 619/220-4815
Fax 619/220-4816
E-Mail longevity4me@juno.com
Mail your order to:
     Longevity Herbs
     3753 Sixth Avenue
     San Diego, CA 92103

Wholesale inquiries are welcome, please call.

Tincture Price List (Special orders are available by request)
Tincture Quantity 4 oz. 8 oz. 16 oz. 32 oz. Extended
Total
Anemarrhena, Phell. & Rehmannia   $48.99 $68.99 $129 $170  
Astragalus & Ganoderma   $48.99 $68.99 $129 $170  
Bupleurum & Cinnamon   $48.99 $68.99 $129 $170  
Bupleurum & Dang Gui Decoction   $48.99 $68.99 $129 $170  
Bupleurum & Dragon Bone   $48.99 $68.99 $129 $170  
Bupleurum & Peony   $48.99 $68.99 $129 $170  
Capillaris & Hoelen Decoction   $48.99 $68.99 $129 $170  
Cardamon & Fennel   $48.99 $68.99 $129 $170  
Chianghuo & Tumeric   $48.99 $68.99 $129 $170  
Cinnamon & Astragalus   $48.99 $68.99 $129 $170  
Cinnamon & Hoelen   $48.99 $68.99 $129 $170  
Cinnamon Twig Decoction   $48.99 $68.99 $129 $170  
Citurs & Cratagus   $48.99 $68.99 $129 $170  
Citrus & Pinellia   $48.99 $68.99 $129 $170  
Clematis & Stephania Decoction   $48.99 $68.99 $129 $170  
Coix Plus Decoction   $48.99 $68.99 $129 $170  
Coptis & Scute   $48.99 $68.99 $129 $170  
Curing Decoction   $48.99 $68.99 $129 $170  
Dang Gui & Arctium Decoction   $48.99 $68.99 $129 $170  
Dang Gui & Peony   $48.99 $68.99 $129 $170  
Dang Gui & Tribulus   $48.99 $68.99 $129 $170  
Dang Gui Four (4 Substance)   $48.99 $68.99 $129 $170  
Dianthus Decoction   $48.99 $68.99 $129 $170  
Echinacea & Goldenseal   $25 $33 $46 $65  
Gastrodia & Uncaria Decoction   $48.99 $68.99 $33 $170  
Gentiana Decoction   $48.99 $68.99 $129 $170  
Ginseng & Astragalaus   $48.99 $68.99 $129 $170  
Ginseng & Atractylodes   $48.99 $68.99 $129 $170  
Ginseng & Dang Gui 10 Decoction   $48.99 $68.99 $129 $170  
Ginseng & Longan   $48.99 $68.99 $129 $170  
Ginseng & Zizyphus Decoction   $48.99 $68.99 $129 $170  
Ginseng Nutritive   $48.99 $68.99 $129 $170  
Happy Tea   $48.99 $68.99 $129 $170  
Hoelen Five Decoction   $48.99 $68.99 $129 $170  
Honeysuckle & Forsythia Decoction   $48.99 $68.99 $129 $170  
Immune Building Mushroom Combo   $48.99 $68.99 $129 $170  
Istatis Plus   $48.99 $68.99 $129 $170  
Jade Windscreen   $48.99 $68.99 $129 $170  
Jin Gu Decoction   $48.99 $68.99 $129 $170  
Linking Decoction   $48.99 $68.99 $129 $170  
Longevity Decoction   $48.99 $68.99 $129 $170  
Lycii, Chrysanthemum & Rehmannia   $48.99 $68.99 $129 $170  
Magnolia Flower Decoction   $48.99 $68.99 $129 $170  
Mahuang & Apricot Decoction   $48.99 $68.99 $129 $170  
Mahuang & Ginko   $48.99 $68.99 $129 $170  
Mahuang & Morus   $48.99 $68.99 $129 $170  
Major Four Decoction (4 Gentlemen)   $48.99 $68.99 $129 $170  
Major Six (6 Gentlemen)   $48.99 $68.99 $129 $170  
Minor Blue Dragon Decoction   $48.99 $68.99 $129 $170  
Minor Bupleurum Decoction   $48.99 $68.99 $129 $170  
Minor Cinnamon & Peony   $48.99 $68.99 $129 $170  
Minor Rhubarb Decoction   $48.99 $68.99 $129 $170  
Ophiopogonus & Asarum   $48.99 $68.99 $129 $170  
Ophiopogonus Decoction   $48.99 $68.99 $129 $170  
Passwan Decoction   $48.99 $68.99 $129 $170  
Peony & Licorice Decoction   $48.99 $68.99 $129 $170  
Pinellia & Magnolia   $48.99 $68.99 $129 $170  
Pinellia "X" Decoction   $48.99 $68.99 $129 $170  
Platycodi & Fritillaria   $48.99 $68.99 $129 $170  
Pueraria Decoction   $48.99 $68.99 $129 $170  
Pueraria Nasal   $48.99 $68.99 $129 $170  
Rehmannial Eight   $48.99 $68.99 $129 $170  
Rehmannia Six   $48.99 $68.99 $129 $170  
Restore the Right Decoction   $48.99 $68.99 $129 $170  
Restore the Left Decoction   $48.99 $68.99 $129 $170  
Salvia Decoction   $48.99 $68.99 $129 $170  
Saussurea & Cardamon   $48.99 $68.99 $129 $170  
Shou Wu Decoction   $48.99 $68.99 $129 $170  
Soothe the Liver Decoction   $48.99 $68.99 $129 $170  
To Jing Decoction   $48.99 $68.99 $129 $170  
Women's Precious   $48.99 $68.99 $129 $170  
Zhong Gan Ling   $48.99 $68.99 $129 $170  
Zizyphus Decoction   $48.99 $68.99 $129 $170  
Grand Total:  

Raw Herbs Price List
Herb Quantity 4 oz. 8 oz. 16 oz. 32 oz. Extended
Total
Angelica - Dang Gui   $5 $9 $18 $30  
Astragalus - Huang Qi   $5 $9 $18 $30  
Atractylodes - Bai Zhu   $4 $8 $12 $16  
Bupleurum - Chai Hu   $6 $12 $24 $34  
Chinese Dates - Da Zao   $4 $8 $12 $16  
Chrysanthemum - Ju Hua   $4 $8 $12 $16  
Cinnamon Twig - Gui Zhi   $4 $8 $12 $16  
Citrus (Mandarin Orange)
Peel - Chen Pi		   $4 $8 $12 $16  
Corydalis - Yan Hu Suo   $6 $12 $24 $34  
Dandelion - Pu Gong Ying   $3 $6 $12 $20  
Dioscorea - Shan Yao   $6 $12 $24 $34  
Ginger (Dry) - Gan Jiang   $5 $10 $20 $25  
Ginkgo - Bai Guo Ye   $5 $10 $20 $25  
Ginseng (Red) - Ren Shen   $15 $30 $60 $100  
Ginseng (White) - Jilin   $15 $30 $60 $100  
Honeysuckle - Jin Yin Hua   $6 $12 $24 $34  
Isatis - Ban Lan Gen   $5 $10 $20 $25  
Licorice (Plain) - Gan Cao   $4 $8 $12 $16  
Licorice (Honey-Fried)
- Zhi Gan Cao		   $4 $8 $12 $16  
Ligustici - Chuan Xiong   $4 $8 $12 $16  
Lycii Berries - Gou Qi Zi   $6 $12 $24 $34  
Mint - Bo He   $5 $9 $18 $30  
Platyodi - Jie Geng   $4 $8 $12 $16  
Poria - Fu Ling   $4 $8 $12 $16  
Prepared Rehmannia
- Shu Di Huang		   $4 $8 $12 $16  
Raw Rehmannia
- Sheng Di Huang		   $4 $8 $12 $16  
Reishi (Ganoderma)
- Ling Zhi		   $13 $25 $50 $90  
Rhubarb - Da Huang   $4 $8 $12 $16  
Safflower - Hong Hua   $4 $8 $12 $16  
Salvia - Dan Shen   $4 $8 $12 $16  
Saussarea - Mu Xiang   $4 $8 $12 $16  
Schizandra - Wu Wei Zi   $4 $8 $12 $16  
Senna - Fan Xie Ye   $4 $8 $12 $16  
Shou Wu (Polygoni)
- He Shou Wu		   $4 $8 $12 $16  
3 Yellows (Scutellaria,
Coptis, Phellodendron)		   $4 $8 $12 $16  
White Peony - Bai Shao   $5 $10 $20 $25  
Zizyphus - Suan Zao Ren   $5 $9 $18 $30  
Grand Total:  




SHIPPING:
Please allow 7-10 days for shipping. Shipping and handling rates vary depending upon the weight of the package.

RETURNS:
We do not allow returns on items that have already been opened. If you are returning an unopened item you can receive store credit or a refund.

DISCLAIMER:
It is always advisable to consult with a trained herbalist before adding any supplements to your diet. Longevity Herbs is not liable for any damage or injury resulting from the misuse of our products.