MEDICATION ORDER Order Type* New Order Order Refill Provider* Cory Whitlock, PA-C Dara Vino, PA-C David Plaisance, FNP-C Elizabeth Snedeker, PA-C, MSPAS Katie Nickerson, PA-C Kristen Letendre, PA-C Miklos Major, Sc.D., DNP, NP-BC Nancy Long, FNP-C Viking Location* VIKING - Corporate VIKING - Chesterfield VIKING - TriMax Health and Fitness Choice Date* MM slash DD slash YYYY Patient Name* First Middle Last Date of Birth* MM slash DD slash YYYY Patient's Phone Number*Driver's License #* Patient's Email* HiddenBilling same as shipping? Yes No Billing address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Shipping Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code HSA Card?YesNoHSA Card Number Month/Year 3 digit Security Code Cardholder's name Hormone Replacement Therapy Packages HRT for Male Female Male HRT PackageChoose Desired PackagePackage - Choose desired package typeMake a selection to choose a quantitySelect correct option10 week TRT10 Week TRT (No HCG/Gonadorelin)20 week TRT20 Week TRT (No HCG/Gonadorelin)8 week TRT8 Week TRT (No HCG/Gonadorelin)16 week TRT16 Week TRT (No HCG/Gonadorelin)Package Quantity*Please enter a number from 1 to 1.Anastrozole - 10 weekSelect correct optionSelect correct optionNO ANASTROZOLE#5 Anastrozole 1 mg - Take 1/4 tablet (0.25 mg) by mouth 2x weekly#10 Anastrozole 1 mg - Take 1/4 (0.25 mg) - 1/2 tablet (0.5 mg) by mouth 2x weekly#10 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 2x weekly#15 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 3x weekly#20 Anastrozole 1 mg - Take 1/2 tablet (0.5mg) - 1 tablet (1 mg) by mouth 2x weekly#20 Anastrozole 1 mg - Take 1 tablet (1 mg) by mouth 2x weekly#30 Anastrozole 1 mg - Take 1 tablet (1 mg) by mouth 3x weeklyAnastrozole - See Notes of Dosage Variation and QTYAnastrozole - 20 weekSelect correct optionSelect correct optionNO ANASTROZOLE#10 Anastrozole 1 mg - Take 1/4 tablet (0.25 mg) by mouth 2x weekly#20 Anastrozole 1 mg - Take 1/4 (0.25 mg) - 1/2 tablet (0.5 mg) by mouth 2x weekly#20 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 2x weekly#30 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 3x weekly#40 Anastrozole 1 mg - Take 1 tablet (1 mg) by mouth 2x weekly#60 Anastrozole 1 mg - Take 1 tablet (1 mg) by mouth 3x weeklyAnastrozole - See dosage variationAnastrozole - 8 weekSelect correct optionSelect correct optionNO ANASTROZOLE#4 Anastrozole 1 mg - Take 1/4 tablet (0.25 mg) by mouth 2x weekly#8 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 2x weekly#16 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 3x weeklyAnastrozole - See dosage variationAnastrozole - 16 weekSelect correct optionSelect correct optionNO ANASTROZOLE#8 Anastrozole 1 mg - Take 1/4 tablet (0.25 mg) by mouth 2x weekly#16 Anastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 2x weeklyAnastrozole - See dosage variationExemestane - 8 weekSelect Correct OptionSelect Correct Option#8 Exemestane 25 mg - Take 1/2 tablet (12.5 mg) by mouth 2x weekly#16 Exemestane 25 mg - Take 1 tablet (25 mg) by mouth 2x weeklyExemestane - 10 weekSelect Correct OptionSelect Correct Option#10 Exemestane 25 mg - Take 1/2 tablet (12.5 mg) by mouth 2x weekly#20 Exemestane 25 mg - Take 1 tablet (25 mg) by mouth 2x weeklyExemestane - 20 weekSelect Correct OptionSelect Correct Option#20 Exemestane 25 mg - Take 1/2 tablet (12.5 mg) by mouth 2x weekly#40 Exemestane 25 mg - Take 1 tablet (25 mg) by mouth 2x weeklyGonadorelin - 10 weekSelect correct optionSelect Correct OptionGonadorelin 1mg - 2 vials - Inject 50 units by subcutaneous route 2x weeklyGonadorelin 1mg - 3 vials - Inject 50 units by subcutaneous route 3x weekly - Additional #10 insulin syringesGonadorelin - 20 weekSelect correct optionSelect Correct OptionGonadorelin 1mg - 4 vials - Inject 50 units (0.5mg) by subcutaneous route 2x weeklyHCG - 10 weekSelect correct optionSelect Correct OptionHCG 5000 iu -Inject 25 units (250 iu) by subcutaneous route 2x weeklyHCG 11000 iu -Inject 50 units (500 iu) by subcutaneous route 2x weeklyHCG 11000 iu- 2 vials -Inject 50 units (500 iu) by subcutaneous route 3x weeklyHCG 11000 iu- 2 vials -Inject 50 units (500 iu) by subcutaneous route EVERY OTHER DAYHCG - 20 weekSelect correct optionSelect Correct OptionHCG 5000 iu - 2 vials - Inject 25 units (250 iu) by subcutaneous route 2x weeklyHCG 11000 iu -2 vials - Inject 50 units (500 iu) by subcutaneous route 2x weeklyHCG Troche - 8 weekSelect correct optionSelect Correct OptionHCG 500iu Troche - #20 - Dissolve 1 troche sublingually 2x per weekHCG 500iu Troche - #30 - Dissolve 1 troche sublingually 3x per weekHCG 500iu Troche - #60 - Dissolve 1 troche sublingually every dayHCG Troche - 16 weekSelect correct optionSelect Correct OptionHCG 500iu Troche - #40 - Dissolve 1 troche sublingually 2x per weekHCG 500iu Troche - #60 - Dissolve 1 troche sublingually 3x per weekHCG 500iu Troche - #120 - Dissolve 1 troche sublingually every dayTestosterone Cream - 8 weekSelect correct optionChoose correct optionTestosterone Cream 200 MG/GM (20%) - 30 GM - Apply 1 click in the AM and 1 click in the PMTestosterone Cream 200 MG/GM (20%) - 60 GM - Apply 2 clicks in the AM and 2 clicks in the PMTestosterone Cream - 16 weekSelect correct optionChoose correct optionTestosterone Cream 200 MG/GM (20%) - 120 GM - Apply 2 clicks in the AM and 2 clicks in the PMTestosterone Troche - 8 weekSelect correct optionChoose correct optionTestosterone Troche 50 mg - #60- Dissolve 1/2 (25 mg) troche under tongue every morning and eveningTest/Cyp 200 MG/mL - 10 weekSelect Correct OptionSelect Correct OptionTest/Cyp 200 mg/ml - 5 ml - Inject 0.2 ml (40 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 5 ml - Inject 0.25 ml (50 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.3 ml (60 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.35 ml (70 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.375 mL (75 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.4 mL (80 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.425 mL (85 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.45 ml (90 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 10 ml - Inject 0.5 ml (100 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 15 ml - Inject 0.6 ml (120 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 15 ml - Inject 0.625 ml (125 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 15 ml - Inject 0.75 ml (150 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 20 mL - Inject 1 ml (200 mg) by intramuscular route 2x weeklyTest/Cyp 200 MG/mL - 20 weekSelect Correct OptionSelect Correct OptionTest/Cyp 200 mg/ml - 15 ml - Inject 0.3 ml (60mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 20 ml - Inject 0.4 ml (80mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 20 ml - Inject 0.5 ml (100mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 25 ml - Inject 0.625 ml (125 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 30 ml - Inject 0.75 ml (150 mg) by intramuscular route 2x weeklyTest/Cyp 200 mg/ml - 40 ml - Inject 1 ml (200mg) by intramuscular route 2x weeklyHiddenTest/Prop - 10 weekSelect correct optionSelect Correct OptionTest/Prop 200 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Prop 200 MG/mL - 20 mL - Inject 1 mL by intramuscular route 2x weeklyHiddenTest/Prop - 20 weekSelect correct optionSelect Correct OptionTest/Prop 200 MG/mL - 20 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Prop 200 MG/mL - 40 mL - Inject 1 mL by intramuscular route 2x weeklyTest/Cyp/Prop - 10 weekSelect correct optionSelect Correct OptionTest/Cyp/Prop 180/20 mg/ml - 10 ml - Inject 0.5 (100 mg) ml by intramuscular route 2x weeklyTest/Cyp/Prop 180/20 mg/ml - 20 ml - Inject 1 (200 mg) ml by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 mg/ml - 10 ml - Inject 0.4 ml (96 mg) by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 mg/ml - 10 ml - Inject 0.5 ml (120 mg) by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 mg/ml - 20 ml - Inject 1 ml (240 mg) by intramuscular route 2x weeklyTest/Cyp/Prop - 20 weekSelect correct optionSelect Correct OptionTest/Cyp/Prop 180/20 mg/ml - 20 ml - Inject 0.5 ml (100 mg) by intramuscular route 2x weeklyTest/Cyp/Prop 180/20 mg/ml - 40 ml - Inject 01 ml (200 mg) by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 MG/ml - 20 ml - Inject 0.5 ml (120 mg) by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 mg/ml - 40 ml - Inject 1 ml (240 mg) by intramuscular route 2x weeklyTest/Enanthate - 10 weekSelect correct optionSelect Correct OptionTest/Enanthate 200 mg/ml - 10 ml - Inject 0.5 ml (100 mg) by intramuscular route 2x weeklyTest/Enanthate 200 mg/ml - 15 ml - Inject 0.75 ml (150 mg) by intramuscular route 2x weeklyTest/Enanthate 200 mg/ml - 20 ml - Inject 1 ml (200 mg) by intramuscular route 2x weeklyTest/Enanthate - 20 weekSelect correct optionSelect Correct OptionTest/Enanthate 200 mg/ml - 20 ml - Inject 0.5 ml (100 mg) by intramuscular route 2x weeklyTest/Enanthate 200 mg/ml - 40 ml - Inject 1 ml (200 mg) by intramuscular route 2x weeklySyringe Options - 10 week*Select Correct OptionSelect Correct OptionNo Syringes#20 IM syringes/#20 insulin syringes#40 insulin syringes (replace IM syringes for insulin syringes)Syringe Options -No HCG - 10 week*Select Correct OptionSelect Correct OptionNo Syringes#20 IM syringes#20 insulin syringes (replace IM syringes for insulin syringes)Syringe Options - 20 week*Select Correct OptionSelect Correct Option#40 IM syringes/#40 insulin syringes#80 insulin syringes (replace IM syringes for insulin syringes)Syringe Options - No HCG - 20 week*Select Correct OptionSelect Correct OptionNo Syringes#40 IM syringes#40 insulin syringes (replace IM syringes for insulin syringes)Female HRT PackageChoose Desired PackageFemale Package - Choose desired package typeMake a selection to choose a quantitySelect correct option10 week TRT10 Week TRT (No Progesterone)20 week TRT20 Week TRT (No Progesterone)8 week TRT8 Week TRT (No Progesterone)16 week TRT16 Week TRT (No Progesterone)Package Quantity*Please enter a number from 1 to 1.Progesterone - 8 weekSelect correct optionSelect Correct OptionProgesterone 50 MG - #60 -Take 1 capsule (50 mg) by mouth every nightProgesterone 100 MG - #60 -Take 1 capsule (100 mg) by mouth every nightProgesterone 200 MG - #60 -Take 1 capsule (200 mg) by mouth every nightProgesterone - 16 weekSelect correct optionSelect Correct OptionProgesterone 50 MG - #120 -Take 1 capsule (50 mg) by mouth every nightProgesterone 100 MG - #120 -Take 1 capsule (100 mg) by mouth every nightProgesterone 200 MG - #120 -Take 1 capsule (200 mg) by mouth every nightProgesterone - 10 weekSelect correct optionSelect Correct OptionProgesterone 50 MG - #70 -Take 1 capsule (50 mg) by mouth every nightProgesterone 100 MG - #70 -Take 1 capsule (100 mg) by mouth on day 14-27 of cycleProgesterone 100 MG - #70 -Take 1 capsule (100 mg) by mouth every nightProgesterone 200 MG - #70 -Take 1 capsule (200 mg) by mouth every nightProgesterone - 20 weekSelect correct optionSelect Correct OptionProgesterone 50 MG - #140 -Take 1 capsule (50 mg) by mouth every nightProgesterone 100 MG - #140 -Take 1 capsule (100 mg) by mouth every nightProgesterone 200 MG - #140 -Take 1 capsule (200 mg) by mouth every nightTestosterone Cream - 8 weekSelect correct optionSelect Correct OptionTestosterone Cream 10 MG/GM (1%) - 15 GM - Apply 1 click daily as directedTestosterone Cream 10 MG/GM (1%) - 30 GM - Apply 1 click in the AM and 1 click in the PMTestosterone Cream - 16 weekSelect correct optionSelect Correct OptionTestosterone Cream 10 MG/GM (1%) - 30 GM - Apply 1 click daily as directedTestosterone Cream 10 MG/GM (1%) - 60 GM - Apply 1 click in the AM and 1 click in the PMTest/Cyp 200 MG/mL - 10 weekSelect correct optionSelect Correct OptionTest/Cyp 200 MG/mL - 1 mL - Inject 0.1 mL 1x every 14 daysTest/Cyp 200 MG/mL - 1 mL - Inject 0.05 mL (5 units) 1x every 10 daysTest/Cyp 200 MG/mL - 1 mL - Inject 0.05 mL (5 units) 1x every 7 daysTest/Cyp 200 MG/mL - 1 mL - Inject 0.1 mL 1x every 10 daysTest/Cyp 200 MG/mL - 1 mL - Inject 0.1 mL 1x every 7 daysTest/Cyp 200 MG/mL - 2 mL - Inject 0.2 mL 1x every 10 daysTest/Cyp 200 MG/mL - 2 mL - Inject 0.2 mL 1x every 7 daysTest/Cyp 200 MG/mL - 2 mL - Inject 0.3 mL 1x every 5 daysTest/Cyp 200 MG/mL - 3 mL - Inject 0.15 mL 2x weeklyTest/Cyp 200 MG/mL - 5 mL - Inject 0.15 mL 3x weeklyTest/Cyp 200 MG/mL - 6 mL - Inject 0.3 mL 2x weeklyTest/Cyp 200 MG/mL - 20 weekSelect correct optionSelect Correct OptionTest/Cyp 200 MG/mL - 2 mL - Inject 0.1 mL 1x every 7 daysTest/Cyp 200 MG/mL - 3 mL - Inject 0.2 mL 1x every 10 daysTest/Cyp 200 MG/mL - 4 mL - Inject 0.2 mL 1x every 7 daysSyringe Options - 10 weekSelect Correct OptionSelect correct option#10 insulin syringes#10 intramuscular syringes (25g x 1")Syringe Options - 20 weekSelect Correct OptionSelect correct option#20 insulin syringesHidden MEDICATIONSAnastrozoleSelect correct optionSelect Correct OptionAnastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth 2x weeklyAnastrozole 1 mg - Take 1/2 tablet (0.5 mg) by mouth every other dayAnastrozole 1 mg - Take 1 tablet (1 mg) by mouth 3x weeklyAnastrozole 1 mg - Take 1 tablet (1 mg) by mouth 2x weeklySee dosage variationQuantityAOD 9604 TrocheSelect correct optionSelect Correct OptionAOD 9604 - 600 MCG - Dissolve 1 troche under tongue every morningQuantityBella #1 - DO NOT USESelect correct optionSelect Correct OptionTopiramate/Burpropion/Naltrexone/B12-Mathylcobalamin/Phentermine - 15MG/65MG/8MG/AMG/20MG Capsule - Take one dailyQuantityPlease enter a number from 1 to 30.Bi-Estrogen CreamSelect correct optionSelect Correct OptionBi-Estrogen Cream - 0.25 MG/G - 30g Topi-Click - Apply 1 click (0.0625 mg) daily as directedBi-Estrogen Cream - 0.25 MG/G - 30g Topi-Click - Apply 2 clicks (0.125 mg) daily as directedBi-Estrogen Cream - 1 MG/G - 15g Topi-Click - Apply 1 click (0.25 mg) daily as directedBi-Estrogen Cream - 1 MG/G - 15g Topi-Click - Apply 2 clicks (0.50 mg) daily as directedBi-Estrogen Cream - 5 MG/G - 30g Topi-Click - Apply 2 clicks daily (2.5mg) as directedQuantityBPC157 Vial & Capsule - HALLANDALE ONLYSelect correct optionSelect Correct OptionBPC157 - 10 MG vial - Reconstitute w/ 4ml BAC water - Inject 20 units by subcutaneous route 2x weeklyBPC157 - 10 MG vial - Reconstitute w/ 4ml BAC water - Inject 20 units by subcutaneous route dailyBPC157 - 10 MG vial - Reconstitute w/ 4ml BAC water - Inject 30 units by subcutaneous route dailyBPC157 - 500 MCG - Take 1 capsule every day as neededQuantityCabergolineSelect correct optionSelect Correct OptionCabergoline 0.5 MG (#8 tablets) - Take 1/2 tablet (0.25 mg) by mouth 2x weeklyQuantity (1 bottle = 8 Tablets)DO NOT USE - Caffeine/Phentermine/Naltrexone/MethylocobalaminSelect correct optionSelect Correct OptionCaffeine/Phentermine/Naltrexone/Methylocobalamin - 100mg/20mg/8mg/1mg capsule - Take 1 capsule dailyQuantityPlease enter a number from 1 to 30.Clomiphene (Clomid)Select correct optionChoose correct optionClomiphene -25 mg capsule - Take 1 capsule dailyClomiphene -50 mg capsule - Take 1 capsule dailyQuantityDHEASelect correct optionChoose correct optionDHEA -20 mg capsule - Take 1 capsule daily in the morningDHEA -50 mg capsule - Take 1 capsule daily in the morningQuantityECASelect correct optionSelect Correct OptionECA - 20/200/30 mg(#90 capsules) - Take 1 tablet by mouth 1x dailyQuantity (1 bottle = 90 capsules)ExemestaneSelect Correct OptionExemestane 25 MG - Take 1/2 tablet (12.5 mg) by mouth 2x weeklyExemestane 25 MG - Take 1 tablet (25 mg) by mouth 2x weeklySee dosage variationQuantityFinasterideSelect correct optionSelect Correct OptionFinasteride 1 MG - Take 1 tablet (1 mg) by mouth 1x dailyFinasteride 5 MG - Take 1 tablet (5 mg) by mouth 1x dailyQuantityGAC (amino) L-Glutamine 25mg / L-Arginine 100mg / L-Carnitine 200mg - 30ml vialSelect correct optionSelect Correct OptionGAC (amino) L-Glutamine 25mg / L-Arginine 100mg / L-Carnitine 200mg - 30ml vial - Inject 1 mL pre/post workout by intramuscular route AS NEEDEDQuantityGlutathioneSelect correct optionSelect Correct OptionGlutathione 200mg/ml - 10 mL - Inject 0.5 mL by intramuscular route 2x weekly OR AS NEEDEDGlutathione 200mg/ml - 10 mL - Inject 0.5 mL by intramuscular route 3x weekly OR AS NEEDEDGlutathione 200mg/ml - 10 mL - Inject 1 mL by intramuscular route 3x weekly OR AS NEEDEDGlutathione 200mg/ml - 10 mL - Inject 1 mL by intramuscular route daily OR AS NEEDEDGlutathione 200mg/ml - 30 mL - Inject 0.5 mL by intramuscular route 2x weekly OR AS NEEDEDGlutathione 200mg/ml - 30 mL - Inject 0.5 mL by intramuscular route 3x weekly OR AS NEEDEDGlutathione 200mg/ml - 30 mL - Inject 1 mL by intramuscular route 3x weekly OR AS NEEDEDGlutathione 200mg/ml - 30 mL - Inject 1 mL by intramuscular route daily OR AS NEEDEDQuantityGonadorelin - 5 WEEK VIALSelect Correct OptionGonadorelin 1mg Vial - Inject 50 units by subcutaneous route 2x weeklyGonadorelin 1mg Vial - Inject 50 units by subcutaneous route 3x weeklyQuantityHCGSelect correct optionSelect Correct OptionHCG 5000 iu - Inject 25 units (250 iu) by subcutaneous route 2x weeklyHCG 11000 iu - Inject 50 units (500 iu) by subcutaneous route 2x weeklyHCG 500iu Troche - Dissolve 1 troche sublingually 2x per weekQuantityL CarnitineSelect correct optionSelect Correct OptionL Carnitine 500mg/ml - 30 ml vial - Inject 0.5 ml intramuscularly 2x per weekL Carnitine 500mg/ml - 30 ml vial - Inject 1 ml intramuscularly 2x per weekQuantityLetrozoleSelect correct optionSelect Correct OptionLetrozole 2.5 MG - Take 1 tablet (2.5 mg) by mouth 2x weekly AS NEEDEDQuantityLipo CSelect correct optionSelect Correct OptionLipo C - 10 mL - Inject 1 mL by intramuscular route 1x weeklyLipo C - 10 mL - Inject 1 mL by intramuscular route 2x weeklyLipo C - 10 mL - Inject 1 mL by intramuscular route dailyQuantityMagic PillSelect correct optionSelect Correct OptionThe Magic Pill (#60 capsules) - Take 1-2 capsules by mouth 2x dailyQuantity (1 bottle = 60 Capsules)Methylcobalamin B12Select correct optionSelect Correct OptionB12 - 10 mL - Inject 1 mL by intramuscular route 2x weeklyQuantityMIC B12Select correct optionSelect Correct OptionMIC B12 - 30 mL - Inject 1 mL by intramuscular route 2x weeklyQuantityMetforminSelect correct optionSelect Correct OptionMetformin 500 MG - Take 1 tablet (500 mg) by mouth 2x daily AS NEEDEDQuantityModafinil (Provigil)Select correct optionSelect Correct OptionModafinil-200 MG - Take 1/2 -1 tablet (100 mg - 200 mg) by mouth 1x daily AS NEEDEDModafinil-200 MG - Take 1 tablet (200 mg) by mouth 1x daily AS NEEDEDQuantityPlease enter a number from 1 to 30.Nandrolone (Deca)Select correct optionSelect Correct OptionNandrolone (Deca) 200 MG/mL - 10 mL - Inject 0.2 mL (20 units)(40mg) by intramuscular route 2x weeklyNandrolone (Deca) 200 MG/mL - 10 mL - Inject 0.3 mL (30 units)(60mg) by intramuscular route 2x weeklyNandrolone (Deca) 200 MG/mL - 10 mL - Inject 0.4 mL (40 units)(80mg) by intramuscular route 2x weeklyNandrolone (Deca) 200 MG/mL - 10 mL - Inject 0.5 mL (50 units)(100mg) by intramuscular route 2x weeklyQuantityOxandrolone (Anavar)Select correct optionSelect Correct OptionOxandrolone (Anavar) 10 MG- Take 1 capsule (10 mg) by mouth in the AM & PMOxandrolone (Anavar) 25 MG - Take 1 capsule (25 mg) by mouth in the AM & PMQuantityOxymetholone (Anadrol)Select correct optionSelect Correct OptionOxymetholone (Anadrol) 50 MG - Take 1 capsule (50 mg) by mouth 1x dailyQuantityProgesterone CapsulesSelect correct optionSelect Correct OptionProgesterone 50 MG - Take 1 capsule (50 mg) by mouth every nightProgesterone 100 MG - Take 1 capsule (100 mg) by mouth every nightProgesterone 200 MG - Take 1 capsule (200 mg) by mouth every nightProgesterone 300 MG - Take 1 capsule (300 mg) by mouth every nightQuantityProgesterone TrochesSelect correct optionSelect Correct OptionProgesterone 100 MG TROCHE - SEE DOSAGE INSTRUCTIONS BELOWProgesterone 200 MG TROCHE - SEE DOSAGE INSTRUCTIONS BELOWQuantityPhentermineSelect correct optionSelect Correct OptionPhentermine 37.5 MG - Take 1 tablet (37.5 mg) by mouth 1x dailyQuantityPlease enter a number from 1 to 30.PT 141 (Bremelanotide)Select correct optionChoose correct optionBremelanotide (PT-141) 10mg - 2ml vial -0.1 cc by subcutaneous route every 3 days as neededBremelanotide (PT-141) 10mg - 2ml vial -0.2 cc by subcutaneous route every 3 days as neededBremelanotide (PT-141) 10mg - 2ml vial -0.05 cc by subcutaneous route every 3 days as neededBremelanotide (PT-141) 10MG/ML - 5ml nasal sprayExpedited Shipping Charge $75 for states: AL AR CA HI IN MI MN NE NJ QuantityScream Cream (Sildenafil / L-Arginine / Aminophylline / Testosterone Cream)Select correct optionChoose correct optionScream Cream - Sildenafil / L-Arginine / Aminophylline / Testosterone Cream - 15g - Apply 1-2 clicks to genital area as needed 30 minutes prior to sexual activityQuantitySecretagogue - CJC 1295 / Sermorelin / Ipamorelin TrocheSelect Correct OptionChoose correct optionCJC 1295 / Sermorelin / Ipamorelin - 300 mcg / 300 mcg / 300 mcg - Dissolve 1 troche under tongue nightlyQuantitySecretagogue - Duo-Blend Vial & TrocheSelect correct optionChoose correct optionDuo Blend -Ipamorelin/CJC-1295 9mg/5mg vial -Inject 0.1ml (10 units) every evening on empty stomach. 6ml bacteriostatic waterDuo Blend -Ipamorelin/CJC-1295 9mg/5mg vial -Inject 0.2ml (20 units) every evening on empty stomach. 6 ml bacteriostatic waterDuo Blend -Ipamorelin/CJC-1295 9mg/5mg vial -Inject 0.2ml (20 units) every evening on empty stomach. 9ml bacteriostatic waterDuo Blend -Ipamorelin/CJC-1295 9mg/5mg vial -Inject 0.4ml (40 units) daily. 9ml bacteriostatic waterCJC 1295 / Ipamorelin - 300 mcg / 300 mcg - Dissolve 1 troche under tongue nightlyQuantitySecretagogue - Ipamorelin Vial & TrocheSelect Correct OptionIpamorelin - 9 mg vial - Inject 10 units (125 mcg) or 0.2 ml nightly on an empty stomach. 6ml bacteriostatic waterIpamorelin - 9 mg vial - Inject 20 units (250 mcg) or 0.2 ml nightly on an empty stomach. 6ml bacteriostatic waterIpamorelin - 300 mcg- Dissolve 1 (300 mcg) troche under tongue or side of cheek at bedtime nightlyQuantitySecretagogue - MK-677Select correct optionChoose correct optionIbutamoren Mesylate (MK-677) 25mg Capsule - Take 1 capsule dailyQuantitySecretagogue - Sermorelin Vial & TrocheSelect correct optionChoose correct optionSermorelin - 15 mg vial - Inject 10(250mcg) units 0.1 ml nightly on empty stomach. Reconstitute with 6ml Bac WaterSermorelin - 15 mg vial - Inject 20(500mcg) units 0.2 ml nightly on empty stomach. Reconstitute with 6ml Bac WaterSermorelin - 400 mcg- Dissolve 1 (400 mg) troche under tongue or side of cheek at bedtime nightlyQuantitySecretagogue - Sermorelin / Ipamorelin TrocheSelect Correct OptionChoose correct optionSermorelin / Ipamorelin - 300 mcg / 300 mcg - Dissolve 1 troche under tongue nightlyQuantitySildenafil (Viagra)Select correct optionSelect Correct OptionSildenafil (Viagra) 20 MG - Take 1 tablet (20 mg) by mouth 1x daily AS NEEDEDSildenafil (Viagra) 100 MG - Take 1 tablet (100 mg) by mouth 1x daily AS NEEDEDQuantityTadalafil (Cialis)Select correct optionSelect Correct OptionTadalafil (Cialis) 20 mg Tablet - Take 1/4 tablet (5 mg) by mouth 1x daily AS NEEDEDTadalafil (Cialis) 20 mg Tablet - Take 1/2 tablet (10 mg) by mouth 1x daily AS NEEDEDTadalafil (Cialis) 20 mg Tablet - Take 1/2 tablet (10 mg) by mouth every other dayTadalafil (Cialis) 20 mg Tablet - Take 1 tablet (20 mg) by mouth 1x daily AS NEEDEDTadalafil (Cialis) 20 mg Tablet - Take 1 tablet (20 mg) by mouth every other dayTadalafil (Cialis) 25 mg Troche - Dissolve 1 troche (25 mg) under tongue 1x daily AS NEEDEDTadalafil (Cialis) 6 mg Capsule - Take 1 capsule (6 mg) 1x daily AS NEEDEDQuantityTamoxifenSelect correct optionSelect Correct OptionTamoxifen 20 MG - Take 1 tablet (20 mg) by mouth daily AS NEEDEDTamoxifen 20 MG - Take 1 tablet (20 mg) by mouth 2x weekly AS NEEDEDQuantityTB500 - Includes BAC waterSelect correct optionSelect Correct OptionTB500 3mg/ml - 15 mg vial - Inject 15 units by subcutaneous route dailyTB500 3mg/ml - 15 mg vial - Inject 15 units by subcutaneous route 2x weeklyQuantityTest/Cyp - REPLACEMENT VIAL - ORDER DEPT ONLYSelect correct optionSelect Correct OptionTest/Cyp 200 MG/mL - 5 mL - Inject 0.3 mL by intramuscular route 2x weeklyTest/Cyp 200 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Cyp 200 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyQuantityTest/Cyp/Prop - REPLACEMENT VIAL - ORDER DEPT ONLYSelect correct optionSelect Correct OptionTest/Cyp/Prop 160/40 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Cyp/Prop 160/40 MG/mL - 10 mL - Inject 1 mL by intramuscular route 2x weeklyTest/Cyp/Prop 160/40 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Cyp/Prop 180/20 MG/mL - 20 mL - Inject 1 mL by intramuscular route 2x weeklyTest/Cyp/Prop 180/20 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Cyp/Prop 160/40 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 MG/mL - 10 mL - Inject 1 mL by intramuscular route 2x weeklyTest Cyp/Prop/Enanthate 80/80/80 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyQuantityTest/Enanthate - REPLACEMENT VIAL - ORDER DEPT ONLYSelect correct optionSelect Correct OptionTest/Enanthate 200 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Enanthate 200 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Enanthate 200 MG/mL - 10 mL - Inject 1 mL by intramuscular route 2x weeklyQuantityHiddenTest/Prop - REPLACEMENT VIAL - ORDER DEPT ONLYSelect correct optionSelect Correct OptionTest/Prop 200 MG/mL - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyTest/Prop 200 MG/mL - 10 mL - Inject 1 mL by intramuscular route 2x weeklyTest/Prop 200 MG/mL - 5 mL - Inject 0.5 mL by intramuscular route 2x weeklyHiddenQuantityThymosin Alpha 1Select correct optionChoose correct optionThymosin Alpha 1 - 1 spray in each nostril 1x per dayQuantityT3 LiothyronineSelect correct optionSelect Correct OptionLiothyronine (T3) 25 MCG - Take 1 tablet (25 mcg) by mouth in the AMQuantityT4 LevothyroxineSelect correct optionSelect Correct OptionLevothyroxine (T4) 25 MCG - Take 1/2 tablet (25 mcg) by mouth in the AMLevothyroxine (T4) 75 MCG - Take 1 tablet (50 mcg) by mouth in the AMQuantityT3/T4 Liothyronine/LevothyroxineSelect correct optionSelect Correct OptionLiothyronine/Levothyroxine (T3/T4) 9/38 MCG - Take 1 tablet (9/38 mcg) by mouth in the AMQuantityVitamin D (5000iu/ml)Select correct optionSelect Correct OptionVitamin D (5000 iu/mL) - 10 mL - Inject 0.5 mL by intramuscular route 2x weeklyQuantityMisc and suppliesInsulin SyringesSelect correct optionSelect Correct OptionInsulin Syringes 29g 1/2" (1 bag)Insulin Syringes 30g 5/16" (1 bag)Insulin Syringes 31g 5/16" (1 bag)Quantity1 unit = 1 bagIntramuscular Needle/Syringe 3ml - 25g x 1"Select correct optionSelect Correct OptionIntramuscular Needle/Syringe 3ml - 25g x 1"QuantityEXTRA Bacteriostatic WaterSelect correct optionSelect Correct OptionBacteriostatic Water - 30ml vial - Use to reconstitute lyophilized medication as directedQuantityNON TRT PATIENT CONSULTATION FEESelect correct optionSelect Correct OptionNON TRT PATIENT CONSULTATION FEEQuantityPlease enter a number from 1 to 1.Notes/Comments/ Other dosage informationAny other Misc. Products No Yes Any Misc. Products not included aboveTotal Misc. Price Shipping*Choose correct optionFree ShippingHallandale Pharmacy Pick Up (ONLY) - No ChargeShipping ChargeShipping Charge REQUIRES SIGNATUREExpedited Shipping ChargeDiscountTotal $0.00 Discount Price: $0.00
