MHealthy Merchandise Order Form

To order with a credit card fill out the form below.

To order with payroll deduction fill out the form below, print it out and fax or mail it in with this payroll deduction form to:

U.S Mail:
MHealthy Exercise & Relaxation Classes
2850 S. Industrial, Ste. 600
Ann Arbor, MI 48104-7100		 Campus Mail:
MHealthy Exercise & Relaxation Classes
2850 S. Industrial, Ste. 600 / 6773
Fax:
734-975-3012
(internal U-M dial all 7-digits)

Gift Certificates and Punch Cards

Gift Certificates — Gift certificates for any MHealthy product or service are now available in $25 denominations. Gift Certificates for Healthy Cooking Classes are also available for $25 (admits 1 person) or $50 (admits 2 people).

Products & services available to use with your MHealthy gift certificate: Exercise Classes, Fitscript, Personal Training, Fitness Center Memberships, Weight Management, Healthy Cooking Classes, Smoking Cessation and Alcohol Management.
Product Description Price Quantity
$25 Denomination $25
$25 Cooking Class (admit 1) $25
$50 Cooking Class (admit 2) $50
MHealthy Exercise Class Punch Card - Good for 15 visits to any 100 level MHealthy Exercise Class - see our Exercise & Relaxation Classes page for more details. $50
MHealthy Spinning Class Punch Card - In conjunction with Bodies in Balance, 211 E. Ann. Good for 15 Spinning sessions. See our Exercise & Relaxation Classes page for more details. $100
MHealthy Spinning Class Punch Card - In conjunction with 1 on 1 Athletic Club, 2875 Boardwalk St. Good for 15 Spinning sessions. See our Exercise & Relaxation Classes page for more details. $120

Contact Information

(all fields required)
Name
UM or UMHS Department
(write none if not a UM employee)
Street Address or Campus Rm# & Building
City State
Zip or campus box
Email
Daytime Phone#
U-M Empl ID (optional)

Shipping or Pick-up Preference

(required)
U.S. Mail
Campus Mail (dept., room #, bldg. name, & campus zip essential)
I will pick it up at MHealthy’s office, 2850 South Industrial (corner of Eisenhower)

Payment Method

(required)
Credit Card (we are no able to take credit card information over the web at this time. If you wish to pay by credit card please submit this form and call 734-975-3024 to give your card number over the phone.
       Check if you want a receipt
Payroll Deduction (please fill out this form and fax it to 734-975-3012 (If internal U-M dial all seven digits) or mail/drop it off at the address at the top of this page)
Cash/check (please mail/drop off to the address at the top of this page)

Please note that your transaction is not complete until we receive your payment.

Comments

You should receive an email acknowledgement from MHealthy within 24 hours. Your order confirmation should arrive within 24-48 hours. Please review to ensure that the contact information is accurate (if they are not, please call, 734-975-3024, or email MHealthy at mhealthy@umich.edu as soon as possible — we will correct it). Your credit card receipt will be shipped with your merchandise.