• Thank you for your purchase.
  • To allow the safe delivery of your CD ROM or Pain Gone Pen, please supply your delivery address details using the form below.
  • Please fill in the form using CAPITAL LETTERS and allow 28 days for delivery.
  • Having trouble using this form ? Click Here for help.

Enter Your Delivery Address Details Here
Name :
Address 1:
Address 2:
Town / City:
County / State:
Post Code / ZIP:
Country :
Please enter your email address carefully
Email :
* Please choose one option below
Dear Dr. Walker
Please send my Pain Gone Pen to the above address
Please send my CD ROM to the above address.

Additional Message :

* Required

 
FAQs (Frequently Asked Questions)

Why didn't I see a "Delivery Address Confirmation" page after sending my message ?

  • This will happen if you fail to fill in the * Required fields on the form. If you fail to fill in all the required fields you will be returned to a blank form. To make sure I receive your message, please make sure you filll in all those fields marked with an *.

Why didn't I receive a reply to my message ?

  • I may be on holiday - please be patient - I will answer eventually
  • I may be snowed under with the number of messages I have to reply to each day - again please be patient - I will answer eventually
  • You have supplied an incorrect email address - try sending your message again, this time checking your email address carefully.

How do I move between boxes on the form ?

  • The slow way is to click with your mouse on the box you want to type into
  • A faster way is to press the <TAB> key to move to the next box down, and to hold the <SHIFT> key whilst pressing the <TAB> key to move to the next box up.

How do I generate a paragraph in the Message section of the message ?

  • Press the <ENTER> key to generate a paragraph or line break in the main Message box.
  • Don't press the <ENTER> key at any other time, otherwise you'll send me a blank email.

How do I clear the form and start over again ?

  • Press the <Clear Form> button at the bottom of the form to wipe the whole form clear and start over again.

How do I send my email ?

  • When you've finished composing your Message, enter the <Anti-spam> password as requested, and then click on the <Send Email> button to send it. Don't forget to do this, otherwise I won't receive it.

What do I do if the form doesn't work properly ?

  • Should this form not function properly, please email me instead.
 
 
 
 
 
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