Order for Supplements: Pickup or Shipment

PLEASE NOTE: TO EXPEDITE YOUR PRESCRIPTION REFILL,
PLEASE SUBMIT REQUESTS HERE

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• NOTE ON ANNIVERSARY SALE: Your order will be ready for pickup on Monday to qualify for the sale. If you need this immediately (at regular price), please check the box below.

• Name*
  First Last
• Email*
• Phone*
• Text Messages
  Please check this box if it is ok to text you at this number. It will ONLY be used for order questions or notifications.
  • OK to text with order questions or notifications.

• How to Order

  Either send us a picture of the items you need or enter them individually in the text fields below.

• Picture
  Please take a picture of the items you'd like to order. We will include one of each item. If you need more, please specify in the notes field below. Note: The maximum number of images is 4.
  Drop files here or Select files

  Accepted file types: jpg, png, Max. file size: 9 MB, Max. files: 4.
• Write-in Products
  Please include the brand, dosage, and bottle size. Unsure? Enter "x" in "Check My History." To add more, click the plus button.

  Product Name, Strength, and Bottle Size	Brand	Order Quantity	Check My History (enter "x")

• Curbside Pickup or Shipping*
  • I will be picking my order up.
  • Please ship my order (additional $5 USPS cost).
• Shipping Address*
  Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code

• Payment

  We will call you for payment information and estimated order completion time within one business day.
• Have a card on file with us?
  Check here to authorize charging your card for this order.
  • Please charge my card on file.
• Notes
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