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UHS Essential Health Philippines, Inc.

Makati Office

Philippine Authorization to 24th Floor, Tower 1,


The Enterprise Center,
6766 Ayala Avenue corner Paseo
Collect Products Form De Roxas Makati City, 1223
Davao Office
7th Floor, Abreeza Corporate Center
JP Laurel Ave., Davao City, 8000
Cebu Office
5th Floor, Tech Tower
Cebu Business Park, Cebu City,
Cebu, 6000
Phone Order Line - (632) 8858-4500
1-800-108726200 PDLT Toll Free.
CustomerServicePH@usanainc.com
Online Ordering - www.usana.com

To USANA Associate Services:


Hannah
I, ______________________________________________ (USANA ID:_____________________________),
would like to authorize Mr./Ms. _____________________________________________________ (Full Name),
(Photo ID#: _____________________________) to collect on my behalf the following order(s) of products that
I have placed with USANA.

Sales Order Number: ___________________________________


(This order only)

My Auto Order for _____________________ / ______________


(One time only) Month Year

All outstanding, and future orders that I place with UHS Essential Health Philippines, Inc.
(A standing instruction)

Insert REQUIREMENTS:
1. Form bearing all required signatures; and
2. Two (2) government issued I.D.s with signature.
(for account owner and the authorized person)

I understand that the person above will be responsible to verify that the products he/she receives are correct
and in good order, and I will not hold USANA responsible for any discrepancies that may arise.

January 01
Associate's Signature ____________________________________ Date yEAR

Please make a photocopy for your records.

 CCR-017046 PH-EN 05/2021

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