Zyban, The Easy Way To Stop Smoking
(Zyban, Stop Smoking Order Form)

Congratulations, You Are On Your Way To The Easiest Way To Stop Smoking
(free discreet next day shipping on all Zyban orders)

Easy Way To Stop Smoking Fortunately, there is medication that has been clinically proven to decrease your cravings for nicotine. Zyban (bupropion hydrochloride) is the first non-nicotine containing, oral medication that is approved as an aid to help you stop smoking. Zyban decreases your cravings, withdrawal symptoms, and your desire to smoke. Zyban has been shown in clinical trials to not only help with smoking cessation but to also decrease the weight gain that is often associated with smoking cessation.

When smokers, who are addicted to cigarettes, quit smoking they often suffer from symptoms that can be psychological, emotional, or physical in nature. This is known as withdrawal. Zyban allows individuals to successfully quit smoking by reducing the cravings for cigarettes and/or the urge to smoke.

Zyban also reduces the following withdrawal symptoms associated with smoking cessation:

Irritability frustration and/or anger
Anxiety and restlessness
Depressed mood or negative affect
Difficulty concentrating

Zyban is unique from other smoking cessation aides because there is no nicotine - unlike the nicotine patches or gum that just provide an alternate source for nicotine. Zyban works at the neurological level, reducing the actual craving for nicotine. Zyban has helped many smokers, even those who have smoked 10 years or more, put down their cigarettes for good.

When you smoke, nicotine enters the bloodstream through the lungs. It quickly reaches the brain, where it affects certain chemicals that change the way you feel. Eventually, the brain becomes dependent on nicotine to control these chemicals that make you feel "normal." Zyban helps to alleviate this dependency.

Stop smoking today without the nicotine cravings, mood swings, weight gain, etc. Simply complete the following fast and easy order from and we will have your Zyban order discreetly (with no hint of the contents) shipped to you:

Important!

I hereby certify that I am at least eighteen years of age and will carefully read and truthfully answer all of the following questions:

Shipping Address:
First Name:	(required)
Middle Initial:
Last Name:	(required)
Email:	(required)
Confirm Email:	(required)
Address 1:	(required)
Address 2:	(i.e. apt, suite no.)
Town/City:	(required)
Providence/State:	(optional)
Postal / Zip Code:	(required)
Country:	(required)
Phone:	(required for courier purposes only)

Billing Information:
Payment Type:	Credit Card Money Order or Western Union. When paying by money order, the credit card information is not required. The customer service associates will email you with further instructions concerning payment.
Card Holder:	(required for Credit Card Payment Only)
Credit Card Type:	(required for Credit Card Payment Only)
Credit Card No.:	(required for Credit Card Payment Only)
Expiration Date:	(required for Credit Card Payment Only) *Example: 07/08*
CVV2: (Card Verification Value) 0000000000000000	(required for Credit Card Payment Only) For your safety and security, individuals are now required to enter their credit card's verification number (CVV2 code). The verification number is a 3-digit number printed on the back of most credit cards, (the number appears after and to the right of your card number), please refer to the example. If using an American Express card the CVV2 code is a 4-digit number printed on the front of your card, please refer to the example. Please note: By providing the CVV2 code this helps to insure that the credit card is in the possession of the user helping to decrease fraudulent charges.

Billing Address: The next section addresses the actual billing address where the credit card statement is mailed each month. Please enter the exact address of where the credit card statement is sent each month for payment. This address will be verified with the issuing credit card company prior to charging the credit card. The billing address must exactly match the address on file where the credit card statement is mailed each month, or the charges will not be approved. This represents just another security measure taken by the Euro Drugs Pharmacy to prevent fraudulent charges.
Country:	(required for Credit Card Payment Only)
Address 1:	(required for Credit Card Payment Only)
Address 2:	(i.e. apt, suite no.)
Town/City:	(required for Credit Card Payment Only)
Providence/State:	(optional)
Postal / Zip Code:	(required for Credit Card Payment Only)

Medical History (Information provided below is protected by patient/physician privacy laws.
This and all the other information you have entered is encrypted and safe during
transmission over the Internet).

Required Personal Information:
Height:	1in = 2.54cm (required)
Weight:	2.2lb = 1kg (required)
Date of Birth:	(required) *Example: 07/02/79*
Sex:	(required)

Medical History: Please read the following list of medical conditions carefully. Be sure to give any explanations if your answer is "yes" to any of the following.
Do you or any of your immediate family have a history of the following medical conditions?
Blood disorders e.g. anemia, hemophilia, hemochromatosis, phlebitis, sickle cell anemia, thalassemia, thrombosis, hypercholesterolemia, etc.
Cancer e.g. brain, breast, bladder, colorectal, endometrial, leukemia, lung, lymphoma, multiple myeloma, ovarian, prostate, skin, testicular, etc.
Cardiovascular disease e.g. angina, arrhythmia, atrial fibrillation, claudication, congestive heart failure, valve disorder, heart attacks, high blood pressure, strokes, etc.
Endocrine disorder e.g. diabetes, goiter, hyperthyroidism, hypothyroidism, pheochromocytoma, thyroiditis, etc.
Eye disorders e.g. cataracts, glaucoma, retinal complications, etc.
Gastrointestinal disorder e.g. acid reflux, hiatal hernia, irritable bowel syndrome (Crohn's disease, ulcerative colitis), polyps, rectal bleeding, ulcers, etc.
Genitourinary disorder e.g. benign prostatic hyperplasia, cysts, endometriosis, pelvic inflammatory disease, etc.
Immune disorders e.g. Hashimoto's disease, eczema, HIV, Graves disease, Sjogrens syndrome, sarcoidosis, sclerodoma, etc.
Kidney (urinary tract) disorder e.g. bladder disorders, cystic disease, glomerular disease, nephrotic syndrome, renal failure, urinary tract complications, etc.
Liver disorder e.g. cirrhosis, Gilbert's syndrome, hepatitis, hemochromatosis, Wilson's disease, etc.
Musculoskeletal e.g. arthritis, back/spine complications, fibromyalgia, gout, lyme disease, muscular dystrophy, myasthenia gravis, osteomalacia, osteoporosis, rickets, spinal cord injury, etc.
Neurological disorder e.g. Alzheimer's disease, epilepsy, head injuries, headaches, Huntington's disease, multiple sclerosis, seizure, etc.
Psychological disorder e.g. anxiety, attention deficit disorder, bipolar disorder, depression, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, etc.
Respiratory disorder e.g. allergic rhinitis, asthma, chronic bronchitis, emphysema, tuberculosis etc.
Other e.g. acne, chemical dependency, menopause, nutritional disorder, obesity, pregnant/nursing, significant trauma, etc.
Do you have a history of any of the medical conditions previously mentioned including Blood disorders, Cancer, Cardiovascular disease, Endocrine disorder, Eye disorders, Gastrointestinal disorder, Genitourinary disorder Immune disorders, Kidney (urinary tract) disorder, Liver disorder Musculoskeletal, Neurological disorder, Psychological disorder, Respiratory disorder, Other conditions (not mentioned)? If yes, please explain. For example, duration of illness, any surgery or treatment (ten year history of hypertension (high blood pressure), Atenolol 50mg one per day - well controlled with medications, Blood pressure 132/84):	Yes No
	0000000

Additional Medical: Please read the following list of medical questions carefully. Be sure to give any explanations if your answer is "yes" to any of the following.
Currently, are you taking any medications (this includes over-the-counter or nonprescription medication, herbal supplements, sports supplements, etc.) If yes, please explain(medication, supplement including dosage):	Yes No
Are you allergic to any medications, supplements or food products? If yes, please explain (medication, supplement, and the allergic reaction experienced):	Yes No
Do you consume more than two servings of alcohol per day or use tobacco products? If yes, please quantify type of product and usage:	Yes No
Do you currently follow a routine exercise program? If yes, please quantify type and amount of exercise:	Yes No
	0000000

Zyban Specific Questions: Please read the following list of medical questions carefully. Be sure to give any explanations if your answer is "yes" to any of the following.
Do you smoke cigarettes, cigars or a pipe and how long have you been smoking? Please explain:
How much do you smoke per day? Please quantify:
Have you attempted to quit smoking in the past? If yes, please explain what cessation aide you used:	Yes No
Are you using any other products that contain nicotine? If yes, please explain:	Yes No
Do you have a history of any of the following medical conditions:? seizures, central nervous system tumor, head injury, brain tumor, diabetes, eating disorder, psychiatric or emotional disorders, heart, liver or kidney disease, etc. If yes, please explain:	Yes No
Are you taking any medications including any of the following: MAO inhibitors (e.g., isocarboxazid, phenelzine, tranylcypromine, pargyline, selegiline, furazolidone), levodopa, theophylline, corticosteroids (e.g., prednisone), seizure medications, sedatives, antivirals (e.g., ritonavir), tranquilizers/psychiatric drugs (e.g., chlorpromazine), other antidepressants (e.g., amitriptyline, Wellbutrin), benzodiazepines (e.g., Ativan, Xanax, Valium), salicylates (e.g., aspirin, salsalate), isoniazid, chlolinesterase inhibitors (e.g., tacrine, donepezil), diabetes medications, morphine, and adrenaline-like drugs (e.g., pseudoephedrine), opiates, cocaine, or stimulants, marijuana, etc. If yes, please explain:	Yes No

Are you pregnant, breast-feeding or planning to conceive? If yes, please explain:	Yes No

Discount Zyban 150mg Prices

60 Zyban 150mg £109.00 + FREE Consultation + FREE shipping =	£109.00
Most Popular Selection! 120 - Zyban 150mg £179.00 + FREE Consult + FREE shipping	£179.00
Best Deal! *180 - Zyban 150mg £249.00 + FREE Consult + FREE shipping	£249.00

*Good News we already offers the cheapest Zyban prices. However, you can now save an additional 15% -20% per Zyban pill when buying a 120 or more Zyban stop smoking pills.

Buy 120 or more Zyban with the discount that is like receiving a free Zyban stop smoking pill for every five Zyban you order.

Special Instructions :

Finally, please list any "special instructions" associated with your order.

Please Note:
Although our pharmacy is based in Europe we must use a merchant account (the service that charges your credit card for Visa, American Express, etc.) that is based in the United States. Therefore, all prices might be converted from Pounds to United States currency base on the conversion rates set forth by your credit card company.

Avoid Delays:
To avoid delays in processing and/or delivery time, please be sure that all of the above questions that are marked as (required) have been properly filled out. Also check to see if you properly selected the quantity you wish to receive.

Next, simply click on the following submit button
and we will promptly process your Zyban order: