Billing / Order Form
Please select your items below.
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If you need something that is not listed here, please enter in more details in the comment/message section below.
If you need something that is not listed here, please enter in more details in the comment/message section below.
Syringes and shipping will be added at an additional cost.
ONLY SUBMIT THIS FORM ONCE. ONCE THIS FORM IS SUBMITTED, PLEASE DO NOT TRY TO REQUEST THE ORDER BY PHONE OR THROUGH THE PATIENT PORTAL OR YOU RISK DOUBLE PROCESSING. Shipping will be added to all orders. Syringes are not included in the Special Peptide Promotion and will be added afterwards.