{"id":628,"date":"2024-04-16T22:46:21","date_gmt":"2024-04-16T22:46:21","guid":{"rendered":"https:\/\/simplefixrx.com\/?page_id=628"},"modified":"2025-06-04T16:38:04","modified_gmt":"2025-06-04T21:38:04","slug":"royal-hive","status":"publish","type":"page","link":"https:\/\/simplefixrx.com\/es\/royal-hive\/","title":{"rendered":"Royal Hive Skincare &#8211; Order"},"content":{"rendered":"\n\n<div class=\"row\"  id=\"row-1887153211\">\n\n\t<div id=\"col-679631929\" class=\"col medium-1 small-12 large-1\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-1929478025\" class=\"col medium-10 small-12 large-10\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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    <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_20'  action='\/es\/wp-json\/wp\/v2\/pages\/628#gf_20' data-formid='20' novalidate><input id=partial_entry_id_20 class=\"partial_entry_id\" type=hidden name=\"partial_entry_id\" value=\"pending\" data-form_id=\"20\"\/>\n        <div id='gf_progressbar_wrapper_20' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>4<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_20_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_63\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br><br>\n<h1 style=\"text-align:center\">Welcome! Get started by completing the simple information below.<\/h1><\/div><div id=\"field_20_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_2'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_20_2' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_4'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_20_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_6'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_6' id='input_20_6' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_20_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_7'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_20_7' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_20_14' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_20_2' class='gform_page' data-js='page-field-id-14' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_20_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_54\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br><br>\n<h1 style=\"text-align:center\">Select a Product<\/h1><\/div><div id=\"field_20_45\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_20_84\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full gfield_price gfield_price_20_84 gfield_product_20_84 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' >Royal Hive Sample Kit<\/legend><div class='gfield_description' id='gfield_description_20_84'><h2 style=\"color:#f8238b;\">Royal Hive Sample Kit<\/h2><br>\nGo on, try it! We know you'll love it!<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_20_84'>\n\t\t\t<div class='gchoice gchoice_20_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='Royal Hive Sample Kit|19'  id='choice_20_84_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_20_84\"   \/>\n\t\t\t\t\t<label for='choice_20_84_0' id='label_20_84_0' class='gform-field-label gform-field-label--type-inline'>Yes, please send me a Royal Hive Skincare sample kit for just $19<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_20_85\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_20_89\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-full gfield_price gfield_price_20_87 gfield_quantity gfield_quantity_20_87 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_89'>Quantity - Royal Hive Complete Set<\/label><div class='gfield_description' id='gfield_description_20_89'><h2 style=\"color:#f8238b;\">Royal Hive Complete Set<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_20_89' class='large gfield_select'  aria-describedby=\"gfield_description_20_89\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_88\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_87 gfield_quantity gfield_quantity_20_87 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_88'>Quantity - Hydration Honey PM Moisturizer<\/label><div class='gfield_description' id='gfield_description_20_88'><h2 style=\"color:#f8238b;\">Hydration Honey PM Moisturizer<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_88' id='input_20_88' class='large gfield_select'  aria-describedby=\"gfield_description_20_88\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_87\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_87 gfield_product_20_87 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_87_1'>Hydration Honey PM Moisturizer<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_87.1' value='Hydration Honey PM Moisturizer' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_87' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_87' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_87.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_87' value='$41.00' aria-describedby=\"gfield_description_20_87\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_87'><p>Crafted in small batches from all-natural products. This is unlike any skincare on the market. Beeswax locks in moisture while preventing acne due to its natural antibacterial and antifungal properties. Propolis also locks in moisture and is used for wound healing in Europe. You will see a difference in your skin after you sleep in this!<\/p>\n<\/div><\/div><div id=\"field_20_72\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-full gfield_price gfield_price_20_73 gfield_quantity gfield_quantity_20_73 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_72'>Quantity - Hydration Honey PM Moisturizer<\/label><div class='gfield_description' id='gfield_description_20_72'><h2 style=\"color:#f8238b;\">Hydration Honey PM Moisturizer<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_72' id='input_20_72' class='medium gfield_select'  aria-describedby=\"gfield_description_20_72\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_78\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_20_83\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_86 gfield_quantity gfield_quantity_20_86 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_83'>Quantity - Royal Hive Anti-Aging Body Oil<\/label><div class='gfield_description' id='gfield_description_20_83'><h2 style=\"color:#f8238b;\">Royal Hive Anti-Aging Body Oil<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_83' id='input_20_83' class='large gfield_select'  aria-describedby=\"gfield_description_20_83\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_86\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_86 gfield_product_20_86 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_86_1'>Royal Hive Anti-Aging Body Oil<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_86.1' value='Royal Hive Anti-Aging Body Oil' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_86' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_86' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_86.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_86' value='$59.00' aria-describedby=\"gfield_description_20_86\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_86'><p>This luxurious body oil can double as a perfume. Only all-natural oils with a heavenly scent will soothe the skin, leaving you feeling like royalty for hours and hours. Created with:<\/p> <p>Vitamin E, almond oil, olive oil, castor oil, and fragrance.<\/p><\/div><\/div><div id=\"field_20_82\" class=\"gfield gfield--type-option gfield--input-type-select gfield--width-full gfield_price gfield_price_20_75 gfield_option_20_75 gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_82'>Size Options<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_82' id='input_20_82' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Travel Size|0' >Travel Size<\/option><option value='Medium|15' >Medium<\/option><option value='Full Size|40' >Full Size<\/option><\/select><\/div><\/div><div id=\"field_20_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_20_48\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_40 gfield_quantity gfield_quantity_20_40 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_48'>Quantity - Royal Hive Daily Moisturize with Zinc Oxide<\/label><div class='gfield_description' id='gfield_description_20_48'><h2 style=\"color:#f8238b;\">Royal Hive Daily Moisturize with Zinc Oxide<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_48' id='input_20_48' class='medium gfield_select'  aria-describedby=\"gfield_description_20_48\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_40\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_40 gfield_product_20_40 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_40_1'>Royal Hive Daily Moisturize with Zinc Oxide<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_40.1' value='Royal Hive Daily Moisturize with Zinc Oxide' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_40' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_40' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_40.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_40' value='$41.00' aria-describedby=\"gfield_description_20_40\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_40'><p>Beeswax, salicylic acid, hyaluronic acid, vitamin E, shea butter, glycolic acid, lactic acid, propolis, olive oil, ceramides, vitamin C, ferulic acid, and zinc oxide (mineral sunscreen).<\/p><\/div><\/div><div id=\"field_20_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_20_70\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_69 gfield_quantity gfield_quantity_20_69 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_70'>Quantity - Royal Honeycomb Body and Hair Smoothing Balm<\/label><div class='gfield_description' id='gfield_description_20_70'><h2 style=\"color:#f8238b;\">Royal Honeycomb Body and Hair Smoothing Balm<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_70' id='input_20_70' class='medium gfield_select'  aria-describedby=\"gfield_description_20_70\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_69\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_69 gfield_product_20_69 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_69_1'>Royal Honeycomb Body and Hair Smoothing Balm<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_69.1' value='Royal Honeycomb Body and Hair Smoothing Balm' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_69' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_69' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_69.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_69' value='$37.00' aria-describedby=\"gfield_description_20_69\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_69'><p>A hair balm made from Shea Butter, Almond Oil, Beeswax, and Signature Royal Hive Fragrance.<\/p><\/div><\/div><div id=\"field_20_33\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_20_80\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_81 gfield_quantity gfield_quantity_20_81 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_80'>Quantity - Anti Acne Facial Polish<\/label><div class='gfield_description' id='gfield_description_20_80'><h2 style=\"color:#f8238b;\">Anti Acne Facial Polish<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_80' id='input_20_80' class='medium gfield_select'  aria-describedby=\"gfield_description_20_80\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_81\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_81 gfield_product_20_81 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_81_1'>Anti Acne Facial Polish<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_81.1' value='Anti Acne Facial Polish' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_81' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_81' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_81.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_81' value='$12.00' aria-describedby=\"gfield_description_20_81\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_81'><p>All-natural facial soap that comes in a mesh hanging bag. Keep the product in the mesh even when using (it helps create lather and keeps it clean!). If you want clear skin with zero chemicals, then this product is for you.<\/p>\n\n<p>Made from castor oil, olive oil, coconut oil, palm oil, beeswax, and fragrance.<\/p><\/div><\/div><div id=\"field_20_76\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_77 gfield_quantity gfield_quantity_20_77 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_76'>Quantity - Blending Nectar- Tinted SPF liquid<\/label><div class='gfield_description' id='gfield_description_20_76'><h2 style=\"color:#f8238b;\">Blending Nectar- Tinted SPF liquid<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_76' id='input_20_76' class='medium gfield_select'  aria-describedby=\"gfield_description_20_76\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_77\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_77 gfield_product_20_77 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_77_1'>DISCONTINUED - Blending Nectar- Tinted SPF liquid<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_77.1' value='DISCONTINUED - Blending Nectar- Tinted SPF liquid' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_77' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_77' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_77.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_77' value='$39.00' aria-describedby=\"gfield_description_20_77\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_77'><p>Guys, this one is for you too! Natural mineral sunscreen SPF 30, silica (no caking) plus mineral color. Available in 3 shades. You can thank us later!<\/p><\/div><\/div><div id=\"field_20_79\" class=\"gfield gfield--type-option gfield--input-type-select gfield--width-full gfield_price gfield_price_20_77 gfield_option_20_77 gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_79'>Color Selection<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_79' id='input_20_79' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Color Options<\/option><option value='Light\/ Med|0' >Light\/ Med<\/option><option value='Med Dark|0' >Med Dark<\/option><option value='Dark|0' >Dark<\/option><\/select><\/div><\/div><div id=\"field_20_50\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_42 gfield_quantity gfield_quantity_20_42 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_50'>Quantity - OCream<\/label><div class='gfield_description' id='gfield_description_20_50'><h2 style=\"color:#f8238b;\">OCream<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_50' id='input_20_50' class='medium gfield_select'  aria-describedby=\"gfield_description_20_50\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_42\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_42 gfield_product_20_42 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_42_1'>DISCONTINUED - OCream<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_42.1' value='DISCONTINUED - OCream' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_42' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_42' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_42.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_42' value='$36.00' aria-describedby=\"gfield_description_20_42\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_42'><p>15ml<\/p>\n<p>Instructions- O Really? Rub on and Enjoy<\/p>\n<p>60 ml<\/p>\n<p>Ingredients: Coconut Oil, Niacin, Menthol, Peppermint, Oils, Coconut Oil, Shea Oil, Lavendar Mica, Titanium Dioxide, Polysorbate, SLSA, Silica.<\/p><\/div><\/div><div id=\"field_20_49\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_41 gfield_quantity gfield_quantity_20_41 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_49'>Quantity - Blending Nectar Foundation<\/label><div class='gfield_description' id='gfield_description_20_49'><h2 style=\"color:#f8238b;\">Blending Nectar Foundation<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_49' id='input_20_49' class='medium gfield_select'  aria-describedby=\"gfield_description_20_49\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_41\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_41 gfield_product_20_41 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_41_1'>DISCONTINUED - Blending Nectar Foundation<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_41.1' value='DISCONTINUED - Blending Nectar Foundation' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_41' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_41' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_41.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_41' value='$39.00' aria-describedby=\"gfield_description_20_41\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_41'><p><strong>Skincare in makeup? Yes, exactly!<\/strong> This combo has all the acids, natural mineral sunscreen SPF 30, silica (no caking), plus mineral color. So creamy, yet it doesn't settle in lines. Available in 3 shades. <strong>You can thank us later!<\/strong><\/p><\/div><\/div><div id=\"field_20_55\" class=\"gfield gfield--type-option gfield--input-type-select gfield--width-full gfield_price gfield_price_20_41 gfield_option_20_41 gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_55'>Color Selection<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_20_55' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Color Options<\/option><option value='Light\/ Med|0' >Light\/ Med<\/option><option value='Med Dark|0' >Med Dark<\/option><option value='Dark|0' >Dark<\/option><\/select><\/div><\/div><div id=\"field_20_51\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_43 gfield_quantity gfield_quantity_20_43 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_51'>Quantity - Baby BumbleBee Belly Rub<\/label><div class='gfield_description' id='gfield_description_20_51'><h2 style=\"color:#f8238b;\">Baby BumbleBee Belly Rub<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_51' id='input_20_51' class='medium gfield_select'  aria-describedby=\"gfield_description_20_51\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_43\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_43 gfield_product_20_43 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_43_1'>DISCONTINUED - Baby BumbleBee Belly Rub<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_43.1' value='DISCONTINUED - Baby BumbleBee Belly Rub' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_43' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_43' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_43.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_43' value='$46.00' aria-describedby=\"gfield_description_20_43\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_43'><p>*For Queen Bees' who are expecting\"- Rub the Royal Jelly on skin to prevent stretch marks of any kind, any place. <\/p>\n<p>Ingredients: Olive Oil, Cocoa Butter, Shea Butter, Vitamin E, Hyaluronic Acid, Silicone, Vitamin C, Lavendar Oil<\/p>\n<p>120ml jar<\/p><\/div><\/div><div id=\"field_20_66\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_67 gfield_quantity gfield_quantity_20_67 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_66'>Quantity - Hydration Honey Sample<\/label><div class='gfield_description' id='gfield_description_20_66'><h2 style=\"color:#f8238b;\">Hydration Honey Sample<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_66' id='input_20_66' class='medium gfield_select'  aria-describedby=\"gfield_description_20_66\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_67\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_67 gfield_product_20_67 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_67_1'>DISCONTINUED - Hydration Honey Sample -  15ml<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_67.1' value='DISCONTINUED - Hydration Honey Sample -  15ml' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_67' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_67' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_67.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_67' value='$10.00' aria-describedby=\"gfield_description_20_67\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_67'><p>Crafted in small batches from all natural products. This is unlike any skincare on the market. Beeswax locks in moisture while preventing acne due to it's natural antibacterial, antifungal properties. We promise this is unlike other skincare product!<\/p>\n<p>Instructions: Use nightly or as needed. <\/p>\n<p>*Use at night. Rub everywhere. Yes, we said it...Everywhere. Feel amazing in the morning.<\/p>\n<p>15 ml<\/p>\n<p>Ingredients: Beeswax, Propolis, Vitamin A, Cermides, Glycolic acid, Lactic acids, Salicylic acid, Hyaluronic Acid, Lavendar oil, Olive Oil, Shea Butter, Silica<\/p><\/div><\/div><div id=\"field_20_23\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_44 gfield_quantity gfield_quantity_20_44 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_23'>Quantity - Hydration Honey Decolletage<\/label><div class='gfield_description' id='gfield_description_20_23'><h2 style=\"color:#f8238b;\">Hydration Honey Decolletage<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_23' id='input_20_23' class='medium gfield_select'  aria-describedby=\"gfield_description_20_23\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_44\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_44 gfield_product_20_44 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_44_1'>DISCONTINUED - Hydration Honey Decolletage* Face, neck, chest<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_44.1' value='DISCONTINUED - Hydration Honey Decolletage* Face, neck, chest' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_44' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_44' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_44.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_44' value='$34.00' aria-describedby=\"gfield_description_20_44\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_44'><p>Crafted in small batches from all natural products. This is unlike any skincare on the market. Beeswax locks in moisture while preventing acne due to it's natural antibacterial, antifungal properties. We promise this is unlike other skincare product!<\/p>\n<p>Instructions: Use nightly or as needed. <\/p>\n<p>*Use at night. Rub everywhere. Yes, we said it...Everywhere. Feel amazing in the morning.<\/p>\n<p>60 ml<\/p>\n<p>Ingredients: Beeswax, Propolis, Vitamin A, Cermides, Glycolic acid, Lactic acids, Salicylic acid, Hyaluronic Acid, Lavendar oil, Olive Oil, Shea Butter, Silica<\/p><\/div><\/div><div id=\"field_20_47\" class=\"gfield gfield--type-quantity gfield--input-type-select gfield--width-half gfield_price gfield_price_20_1 gfield_quantity gfield_quantity_20_1 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_47'>Quantity - Hydration Honey Body<\/label><div class='gfield_description' id='gfield_description_20_47'><h2 style=\"color:#f8238b;\">Hydration Honey Body<\/h2><br><\/div><div class='ginput_container ginput_container_select'><select name='input_47' id='input_20_47' class='medium gfield_select'  aria-describedby=\"gfield_description_20_47\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select Quantity<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/div><div id=\"field_20_1\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-half gfield_price gfield_price_20_1 gfield_product_20_1 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_1_1'>DISCONTINUED - Hydration Honey Body<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_1.1' value='DISCONTINUED - Hydration Honey Body' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_20_1' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_20_1' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_1.2' class='ginput_product_price gform-text-input-reset' id='ginput_base_price_20_1' value='$39.00' aria-describedby=\"gfield_description_20_1\" \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_1'><p>Crafted in small batches from all natural products. This is unlike any skincare on the market. Beeswax locks in moisture while preventing acne due to it's natural antibacterial, antifungal properties. We promise this is unlike other skincare product!<\/p>\n<p>*Use at night. Rub everywhere. Yes, we said it...Everywhere. Feel amazing in the morning.<\/p>\n<p>120ml <\/p>\n<p>Ingredients: Beeswax, Propolis, Vitamin A, Cermides, Glycolic Acid, Lactic Acids, Salicylic Acid, Hyaluronic Acid, Lavendar oil, Olive Oil, Shea Butter, Silica<\/p><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_20_58' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_20_58' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_20_3' class='gform_page' data-js='page-field-id-58' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_20_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_64\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br><br>\n<h1 style=\"text-align:center\">Billing and Shipping Details<\/h1><\/div><fieldset id=\"field_20_5\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Billing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_20_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_20_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_20_5_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                        <label for='input_20_5_1' id='input_20_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_20_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_20_5_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                        <label for='input_20_5_2' id='input_20_5_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_20_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_20_5_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_20_5_3' id='input_20_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_20_5_4_container' >\n                                        <select name='input_5.4' id='input_20_5_4'     aria-required='true'   autocomplete=\"address-level1\" ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_20_5_4' id='input_20_5_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_20_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_20_5_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                    <label for='input_20_5_5' id='input_20_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_20_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_20_16\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Shipping Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    <div id='input_20_16_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_20_16_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='5' name='input_16_copy_values_activated'  \/>\n                                        <label for='input_20_16_copy_values_activated' id='input_20_16_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Same as Billing Address<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_20_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_20_16_1_container' >\n                                        <input type='text' name='input_16.1' id='input_20_16_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                        <label for='input_20_16_1' id='input_20_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_20_16_2_container' >\n                                        <input type='text' name='input_16.2' id='input_20_16_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                        <label for='input_20_16_2' id='input_20_16_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_20_16_3_container' >\n                                    <input type='text' name='input_16.3' id='input_20_16_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_20_16_3' id='input_20_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_20_16_4_container' >\n                                        <select name='input_16.4' id='input_20_16_4'     aria-required='true'   autocomplete=\"address-level1\" ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_20_16_4' id='input_20_16_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_20_16_5_container' >\n                                    <input type='text' name='input_16.5' id='input_20_16_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                    <label for='input_20_16_5' id='input_20_16_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_20_16_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_20_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_20_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_20_4' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_20_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_61\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br><br>\n<h1 style=\"text-align:center\">Payment Details<\/h1><\/div><div id=\"field_20_60\" class=\"gfield gfield--type-shipping gfield--input-type-singleshipping gfield--width-full gfield_price gfield_shipping gfield_shipping_20 field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_60'>Shipping<\/label><div class='gfield_description' id='gfield_description_20_60'><h2>Flat-Rate Shipping<\/h2><\/div><div class='ginput_container ginput_container_singleshipping'>\n\t\t\t\t\t<input type='text' readonly class='ginput_shipping_price gform-text-input-reset' id='input_20_60' name='input_60' value='$9.00' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_20_91\" class=\"gfield gfield--type-coupon gfield--input-type-coupon gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gf_coupon_code_20'>Coupon<\/label><div class='ginput_container' id='gf_coupons_container_20'><div class='ginput_container_coupon'><input id='gf_coupon_code_20' class='gf_coupon_code' onkeyup='DisableApplyButton(20);' onchange='DisableApplyButton(20);' onpaste='setTimeout(function(){DisableApplyButton(20);}, 50);' type='text'    \/><input type='button' disabled='disabled' onclick='ApplyCouponCode(20);' value='Apply' id='gf_coupon_button' class='button'  \/> <img style='display:none;' id='gf_coupon_spinner' src='https:\/\/simplefixrx.com\/wp-content\/plugins\/gravityformscoupons\/images\/spinner.gif' alt='please wait'\/><\/div><div id='gf_coupon_info'><\/div><input type='hidden' id='gf_coupon_codes_20' name='input_91' value=''  \/><input type='hidden' id='gf_total_no_discount_20'\/><input type='hidden' id='gf_coupons_20' name='gf_coupons_20' value='' \/><\/div><\/div><div id=\"field_20_56\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_20_ gfield_total gfield_total_20_ field_sublabel_below gfield--has-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_20_56'>Total<\/label><div class='gfield_description' id='gfield_description_20_56'><h2>Your Total<\/h2><\/div><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_56' id='input_20_56' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_20' \/>\n\t\t\t\t\t\t<\/div><\/div><fieldset id=\"field_20_10\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Credit Card<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_20_10'><span class='ginput_full gform-grid-col' id='input_20_10_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_20_10_supported_creditcards'>Supported Credit Cards: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <input type='text' name='input_10.1' id='input_20_10_1' value=''   onchange='gformMatchCard(\"input_20_10_1\");' onkeyup='gformMatchCard(\"input_20_10_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='true'  \/>\n                                    <label for='input_20_10_1' id='input_20_10_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_20_10_2_container'>\n                                            <fieldset class='ginput_cardinfo_left gform-grid-col' id='input_20_10_2_cardinfo_left'>\n                                            <legend class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/legend>\n                                                <span class='ginput_card_expiration_container ginput_card_field gform-grid-row'>\n                                                   <span class='ginput_card_expiration_month_container gform-grid-col'>\n                                                       <label for='input_20_10_2_month' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                                       <select name='input_10.2[]' id='input_20_10_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='true'  >\n                                                           <option value=''>Month<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                   <span class='ginput_card_expiration_year_container gform-grid-col'>\n                                                       <label for='input_20_10_2_year' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                                       <select name='input_10.2[]' id='input_20_10_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='true'  >\n                                                           <option value=''>Year<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                <\/span>\n                                            <\/fieldset><span class='ginput_cardinfo_right gform-grid-col' id='input_20_10_2_cardinfo_right'>\n                                                <input type='text' name='input_10.3' id='input_20_10_3'   class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='true'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                                <label for='input_20_10_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                             <\/span>\n                                        <\/span><span 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