BIGHORN BOTANICALS, INC.
25 Bighorn Lane Noxon, MT 59853 PH: 406-847-5597 FX: 406-847-5502
Toll Free: 888-847-1223 Email:
RETAIL ORDER FORM
DATE: ______PH: ______FX: ______
Cell:______Email: ______
NAME: ______REFERRED BY: ______
ADDRESS: ______
VISA or MASTERCARD # ______
EXP DATE: ______CODE # ______
Montana Specialty Tinctures
“Formula” indicates a multi-herb tincture. All others are single herb tinctures.
Natural ingredients sustainably wildcrafted or grown without chemicals in NW Montana.
QUANTITY______TOTAL____
SYNERGY-7x FORMULA (Fresh 1:1.5)
(Previously offered as Montana Cold/Flu Formula)
______2 oz bottle w/dropper ….………………………………………….@ 22.50 = ______
______4 oz bottle ………………………………………………………….@ 43.00 = ______
______16 oz bottle (1 pt) ……….……………….………………………..@ 160.00 = ______
CANDIDA FORMULA(Fresh 1:2)
______2 oz bottle w/dropper ……………………………………………..@ 24.50 = ______
______4 oz bottle ………………..………..……………………………….@ 47.00 = ______
______16 oz bottle (1 pt) …….…………………….…………………….. @ 160.00 = ______
RESPIRATORY FORMULA (Fresh 1:1)
______2 oz bottle w/ dropper …………………………………………….@ 22.50 = ______
______4 oz bottle ……………. …..……………………………………….@ 43.00 = ______
______16 oz bottle (1 pt)…………………………………………………..@ 160.00 = ______
BLACK ELDERBERRY (Fresh 1:1) Sambucus nigra
______1oz bottle w/dropper………………………………………………@ 11.00 = ______
______4 oz bottle ……………….…………………………………...... @ 39.00 = ______
______16 oz bottle (1 pt)……….………………………………………….@ 140.00 = ______
DEVIL’S CLUB STEM w/BARK (Fresh 1:2) Oplopanax horridus
______1 oz w/dropper… ……….…………………………………………@ 9.50 = ______
______4 oz bottle ……………………………………………………...... @ 36.00 = ______
______16 ozbottle (1 pt)..…………………………………………………@ 140.00= ______
PRODUCT INFORMATION ON BACK SUB-TOTAL $ ______
Shipping ______
SHIPPED: ______CARRIER:______TOTAL $ ______
(Office use only: PTS ______PTI ______)
RETAIL ORDER FORM
DATE: ______PH: ______FX: ______
Cell: ______Email: ______
NAME: ______REFERRED BY: ______
ADDRESS:______
VISA 0r MASTERCARD # ______
EXP DATE: ______CODE:______
Montana Specialty Tinctures & Salves - page 2
QUANTITY TOTAL
ECHINACEA FLOWER TOP (Fresh 1:2) Echinacea purpurea
______1 oz bottle w/dropper ……………………………………………………………...@ 9.50 = ______
______4 oz bottle …………………………………………………………………………..@ 36.00 = ______
______16 oz bottle (1 pt) …………………………………………………………………...@ 140.00 = ______
LOMATIUM ROOT (Fresh 1:2) Lomatium dissectum
______1 oz bottle w/dropper ……………………………………………………………….@ 9.50 = ______
______4 oz bottle…………………………………………………………………………….@ 36.00 = ______
______16 oz bottle (1 pt) ………………………………………………………………….. @140.00 = ______
RED ALDER CATKINS (Fresh 1:1) Alnus rubra
______1 oz bottle w/dropper ……………………………………………………………….@ 9.50 = ______
______4 oz bottle …………………………………………………………………………...@ 36.00 = ______
______16 oz bottle (1 pt) …………………………………………………………………..@ 140.00= ______
ST. JOHN’S WORT FLOWER TOP (Fresh 1:1) Hypericum perforatum
______1 oz bottle w/dropper ……………………………………………………………… @ 9.50 = ______
______4 oz bottle ……………………………………………………………………………@ 36.00 = ______
______16 oz bottle (1 pt) …………………………………………………………………. @ 140.00= ______
WHITE BIRCH BARK (Dry 1:4) Betula alba
______1 oz bottle w/dropper ……………………………………………………………....@ 11.50 = ______
______4 oz bottle …………………………………………………………………………...@ 44.00 =______
______16 oz bottle (1 pt) ……………………………………………...... @ 160.00 = ______
WILD HUCKLEBERRY (Fresh 1:1) Vaccinium globulare
______1 oz bottle w/dropper ……………………………………………………………….@ 9.50 =______
______4 oz bottle ……………………………………………………………………………@ 36.00 = ______
______16 oz bottle (1 pt) …………………………………………………………………..@ 140.00 = ______
Montana Specialty Salves (ointments)
CANDIDA SALVE - external use only
______1 oz ……………………………………………………………….@ 17.00 = ______
WHITE BIRCH BARK SALVE– external use only
______1 oz ………………………………………………………………...@ 12.50 = ______
SUB-TOTAL $______
PRODUCT INFORMATION ON BACK Shipping ______
TOTAL $ ______
SHIPPED: ______CARRIER: ______
Office use only: PTS ______PTI ______
BIGHORN BOTANICALS, INC.
25 Bighorn Lane Noxon, MT 59853 PH: 406-847-5597 FX: 406-847-5502
Toll Free: 888-847-1223 Email:
RETAIL ORDER FORM
DATE: ______PH: ______FX: ______
Cell: ______Email: ______
NAME: ______REFERRED BY: ______
ADDRESS: ______
CONTACT PERSON: ______REFERRED BY:______
VISA or MASTERCARD # ______
EXP DATE:______CODE # ______
Montana Herb Tea Bags
Herb teas have been used for centuries to boost the immune system, relieve stress, improve digestion, combat inflammation and promote sleep. BLENDS contain more than one herb. SINGLES contain one herb. All are made with fresh herbs, sustainably harvested from the wild or farmed without chemicals in NW Montana. Zip-loc, re-sealable food-grade packaging, protected from light & air.
QUANTITY ___ TOTAL
ECHINACEAwitha hint of Mint (Blend – multi-herb)
______Pkt of 24 bags ……………………………………………@ 8.50 = ______
CANDIDA (Blend - multi-herb)
______Pkt of 24 bags ……………………………………………@ 10.50 = ______
RESPIRATORY (Blend - multi-herb)
______Pkt of 24 bags……………………………………………. @ 10.50 = ______
HAWTHORN BERRY – (Single - Crataegus columbiana)
______Pkt of 24 bags …………………………………………….@ 8.50 = ______
HORSETAIL – (Single - Equisetum arvense)
______Pkt of 24 bags …………………………………………… @ 8.50 = ______
NETTLE LEAF – (Single - Urtica dioica)
______Pkt of 24 bags …………………………………………… @ 8.50 = ______
SPEARMINT LEAF – (Single - Mentha spicata)
______Pkt of 24 bags ……………………………………………..@ 8.50= ______
SUB-TOTAL $ ______
PRODUCT INFORMATION ON BACK Shipping ______
SHIPPED: ______CARRIER:______TOTAL $ ______
(Office use only: PTS ______PTI ______)