List prescriptions and/or supplements needed (please include dosage amount):

(***If Testosterone is included in your order, a signature will be required at time of delivery. You may have your order shipped to your place of business or a local Fed Ex location.)

Your financial information will be kept confidential!
Please allow 24 - 48 hrs for prescription refills to be processed and shipped.
Please allow 24 hours for your supplement orders to be processed and shipped from our office.