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Saved Order Forms

Semaglutide (Higher Doses)

An order form for higher doses of sublingual semaglutide.

Tirzepatide

An order form for sublingual tirzepatide.

Semaglutide

An order form for sublingual semaglutide.

Bio-Idential HRT (Topical)

An order form for HRT topical treatments.

Testosterone

Testosterone must be E-Prescribed. Learn how via your Tutorials tab of the dashboard.

Erectile Dysfunction Urethral Gels

An order form for Urethral Gels for treating Erectile Dysfunction.

(CPP) Vaginismus/Painful Intercourse CONTROLLED

An order form for Chronic Pelvic Pain (CPP) Vaginismus/Painful Intercourse.

Wrinkles

An order form for Wrinkles.

Dark Spots/Melasma

An order form for Dark Spots/Wrinkles.

Proctitis

An order form for Proctitis.

Radiation Proctitis

An order form for Radiation Proctitis.

Pelvic Floor Dysfunction (PFD)

An order form for Pelvic Floor Dysfunction (PFD).

Resistant Ulcerative Proctitis

An order form for Resistant Ulcerative Proctitis.

Hair Loss

An order form for Hair Loss.

Ophthamology

Multiple order forms for Ophthalmology.

Sialorrhea

An order form for Sialorrhea.

Reflux

An order form for Oral Suspensions for Reflux.

Crohn's Disease

An order form for Crohn's Disease.

Ulcerative Colitis

An order form for Ulcerative Colitis.

Irritable Bowel Syndrome

An order form for IBS.

Gastroparesis

An order form for Gastroparesis.

EOS

An order form for EOS or Eosinophilic Colitis.

Clostridium Difficile

An order form for Clostridium Difficile.

Anal / Rectal Spasms

An order form for Anal / Rectal Spasms.

All Purpose Nipple Ointment

An order form for APNO.

Genital Warts

An order form for Genital Warts.

Stretch Marks

An order form for Stretch Marks.

Anal Fissures

An order form for Anal Fissures.

Hemorrhoids

An order form for Hemorrhoids.

Pelvic Pain

An order form for Pelvic Pain.

Endometriosis

An order form for Endometriosis.

Meniere's Disease

An order form for Meniere's Disease.

Polycystic Ovary Syndrome

An order form for Polycystic Ovary Syndrome.

Nausea / Vomiting

An order form for Nausea / Vomiting.

Yeast Infections

An order form for Yeast Infections.

Vaginal Dryness

An order form for Vaginal Dryness. Estradiol, Estriol, Vitamin E suppository etc

Atrophic Vaginosis

An order form for Atrophic Vaginosis.

Bacterial Vaginosis

An order form for Bacterial Vaginosis.

Cervical Dysplasia

An order form for Cervical Dysplasia.

Female Sexual Dysfunction

An order form for Female Sexual Dysfunction.

Vulvodynia

An order form for Vulvodynia.

Neuropathic Pain

An order form for Neuropathic Pain.

Pain

An order form for Pain.

Wounds / Burns w/o Infection

An order form with Wounds / Burns w/o Infection.

Warts

An order form for Warts.

Neuropathic Foot Pain

An order form for Neuropathic Foot Pain.

Foot Pain

An order form for Foot Pain.

Nail Removal

An order form for Nail Removal.

Nail Fungus

An order form for Nail Fungus.

Gout

An order form for Gout.

Foot Cramps

An order form for Foot Cramps.

Heel Spurs

An order form for Heel Spurs.

Painful Wounds

Infected Wounds

An order form for Infected Wounds.

Fungal Skin Infections

An order form for Fungal Skin Infections.

Raynaud's Phenomenon

An order form for Raynaud's Phenomenon.

Diabetic Toes

An order form for Diabetic Toes.

Sweaty Feet

An order form for Sweaty Feet.

Rough / Dry Feet

An order form for Rough / Dry Feet.

Corns / Calluses

An order form for Corns / Calluses.

Burning Foot Syndrome

An order form for Burning Foot Syndrome.

Dry Mouth

An order form for Xerostomia (dry mouth).

Vertigo

An order form for Vertigo.

Tonsillitis / Tonsillectomy

An order form for Tonsillitis / Tonsillectomy.

Sinusitis

An order form for Sinusitis.

Pharyngitis

An order form for Pharyngitis.

Oral Thrush

An order form for Oral Thrush.

Nose Bleeds

An order form for Nose Bleeds.

Nausea (Inner Ear Problems)

An order form for Nausea.

Nasal Polyps

An order form for Nasal Polyps.

Mucositis

An order form for Mucositis.

MRSA Infections

An order form for MRSA Infections.

Local Anesthetics (Otic)

An order form for Local Anesthetics (Otic).

Lichen Planus

An order form for Lichen Planus.

Laryngitis

An order form for Laryngitis.

Herpes Labialis

An order form for Herpes Labialis.

Eosinophilic Esophagitis

An order form for Eosinophilic Esophagitis

Ear Wax Removal

An order form from Ear Wax Removal.

Burning Mouth Syndrome

An order form for Burning Mouth Syndrome.

Biofilms

An order form for Biofilms.

Aphthous Ulcers

An order form for Aphthous Ulcers.

Angular Cheilitis/Cheilosis

An order form for Angular Cheilitis/Cheilosis.

Acne

An order form for Acne.

Rosacea

An order form for Rosacea.

(CPP) Vaginismus/Painful Intercourse

An order form for Chronic Pelvic Pain (CPP) Vaginismus/Painful Intercourse.

Hirsutism

An order form for Hirsutism.

PCOS with Hirsutism & Acne

An order form for PCOS with Hirsutism & Acne.

Hair Loss (Women)

An order form for Hair Loss (Women).

Libido/Sexual Dysfunction (Scream Cream)

An order form for Libido/Sexual Dysfunction (Scream Cream).

Vulvar Lichen Sclerosis

An order form for Vulvar Lichen Sclerosis.

Vaginal Itching

An order form for Vaginal Itching.

Vaginal Procedure Anesthetic (Mona Lista Touch™)

An order form for Vaginal Procedure Anesthetic.

Genital Herpes

An order form for Genital Herpes.

Candida Glabrata

An order form for Candida Glabrata.

Vaginal Infections (Bacterial/Yeast/Combo/Viral)

An order form for treatment of Vaginal Infections.

Vaginal Atrophy / Dryness / Painful Intercourse

An order form for women with Low Estrogen levels.

Bio-Idential HRT (Oral)

An order form for HRT Oral treatments.

Bio-Idential HRT (Vaginal)

An order form for HRT Vaginal treatments.

Blank

A blank order form for you to fill in.

Erectile Dysfunction Orals

Tablets, troches, and Rapid Dissolve Tablets.

Edit or Print Order Form

Go to My Order Form

Go to your order form with the
formulas you added.

Custom Order Forms

Need custom order forms? Contact Us

Topical Anesthetics for Cosmetic Numbing Procedures

This is a test.

Semaglutide (Higher Doses)

An order form for higher doses of sublingual semaglutide.

This order form contains:

Semaglutide

Tirzepatide

An order form for sublingual tirzepatide.

This order form contains:

Tirzepatide

Semaglutide

An order form for sublingual semaglutide.

This order form contains:

Semaglutide

Bio-Idential HRT (Topical)

An order form for HRT topical treatments.

This order form contains:

Estradiol

Estriol

Progesterone

Dehydroepiandrosterone

Testosterone

Testosterone must be E-Prescribed. Learn how via your Tutorials tab of the dashboard.

This order form contains:

Testosterone

Erectile Dysfunction Urethral Gels

An order form for Urethral Gels for treating Erectile Dysfunction.

This order form contains:

Alprostadil

Papaverine

Phentolamine

(CPP) Vaginismus/Painful Intercourse CONTROLLED

An order form for Chronic Pelvic Pain (CPP) Vaginismus/Painful Intercourse.

This order form contains:

Diazepam

Ketamine

Lidocaine

Gabapentin

Wrinkles

An order form for Wrinkles.

This order form contains:

Tretinoin

Niacinamide

Sodium Hyaluronate

Dark Spots/Melasma

An order form for Dark Spots/Wrinkles.

This order form contains:

Hydroquinone

Kojic Acid

Tranexamic Acid

Niacinamide

Tretinoin

Proctitis

An order form for Proctitis.

This order form contains:

Budesonide

Mesalamine

Naltrexone

Sodium Acetate

Sodium Butynate

Radiation Proctitis

An order form for Radiation Proctitis.

This order form contains:

Sucralfate

Pelvic Floor Dysfunction (PFD)

An order form for Pelvic Floor Dysfunction (PFD).

This order form contains:

Baclofen

Resistant Ulcerative Proctitis

An order form for Resistant Ulcerative Proctitis.

This order form contains:

Tacrolimus

Hair Loss

An order form for Hair Loss.

This order form contains:

Minoxidil

Finasteride

Azelaic Acid

Tretinoin

Ophthamology

Multiple order forms for Ophthalmology.

This order form contains:

Tobramycin

Vancomycin

Gentamicin

Ceftriaxone

Atropine

Sialorrhea

An order form for Sialorrhea.

This order form contains:

Scopolamine Hydrobromide

Atropine Sulfate

Glycopyrrolate

Reflux

An order form for Oral Suspensions for Reflux.

This order form contains:

Esomeprazole

Lansoprazole

Omeprazole

Pantoprazole

Crohn's Disease

An order form for Crohn's Disease.

This order form contains:

Budesonide

Mesalamine

Naltrexone

Sodium Acetate

Sodium Butynate

Ulcerative Colitis

An order form for Ulcerative Colitis.

This order form contains:

Budesonide

Mesalamine

Naltrexone

Sodium Acetate

Sodium Butynate

Irritable Bowel Syndrome

An order form for IBS.

This order form contains:

Budesonide

Mesalamine

Naltrexone

Sodium Acetate

Sodium Butynate

Gastroparesis

An order form for Gastroparesis.

This order form contains:

Multiple medications available.

EOS

An order form for EOS or Eosinophilic Colitis.

This order form contains:

Multiple medications available.

Clostridium Difficile

An order form for Clostridium Difficile.

This order form contains:

Vancomycin

Metronidazole

Anal / Rectal Spasms

An order form for Anal / Rectal Spasms.

This order form contains:

Multiple medications available.

All Purpose Nipple Ointment

An order form for APNO.

This order form contains:

Mupirocin

Betamethasone

Miconazole

Genital Warts

An order form for Genital Warts.

This order form contains:

Multiple medications available.

Stretch Marks

An order form for Stretch Marks.

This order form contains:

Multiple medications available.

Anal Fissures

An order form for Anal Fissures.

This order form contains:

Diltiazem

Nifedipine

Nitroglycerin

Hemorrhoids

An order form for Hemorrhoids.

This order form contains:

Multiple medications available.

Pelvic Pain

An order form for Pelvic Pain.

This order form contains:

Multiple medications available.

Endometriosis

An order form for Endometriosis.

This order form contains:

Multiple medications available.

Meniere's Disease

An order form for Meniere's Disease.

This order form contains:

Multiple medications available.

Polycystic Ovary Syndrome

An order form for Polycystic Ovary Syndrome.

This order form contains:

Multiple medications available.

Nausea / Vomiting

An order form for Nausea / Vomiting.

This order form contains:

Multiple medications available.

Yeast Infections

An order form for Yeast Infections.

This order form contains:

Multiple medications available.

Vaginal Dryness

An order form for Vaginal Dryness. Estradiol, Estriol, Vitamin E suppository etc

This order form contains:

Multiple medications available.

Atrophic Vaginosis

An order form for Atrophic Vaginosis.

This order form contains:

Multiple medications available.

Bacterial Vaginosis

An order form for Bacterial Vaginosis.

This order form contains:

Multiple medications available.

Cervical Dysplasia

An order form for Cervical Dysplasia.

This order form contains:

Multiple medications available.

Female Sexual Dysfunction

An order form for Female Sexual Dysfunction.

This order form contains:

Multiple medications available.

Vulvodynia

An order form for Vulvodynia.

This order form contains:

Multiple medications available.

Neuropathic Pain

An order form for Neuropathic Pain.

This order form contains:

Multiple medications available.

Pain

An order form for Pain.

This order form contains:

Multiple medications available.

Wounds / Burns w/o Infection

An order form with Wounds / Burns w/o Infection.

This order form contains:

Multiple medications available.

Warts

An order form for Warts.

This order form contains:

Multiple medications available.

Neuropathic Foot Pain

An order form for Neuropathic Foot Pain.

This order form contains:

Multiple medications available.

Foot Pain

An order form for Foot Pain.

This order form contains:

Multiple medications available.

Nail Removal

An order form for Nail Removal.

This order form contains:

Multiple medications available.

Nail Fungus

An order form for Nail Fungus.

This order form contains:

Multiple medications available.

Gout

An order form for Gout.

This order form contains:

Multiple medications available.

Foot Cramps

An order form for Foot Cramps.

This order form contains:

Multiple medications available.

Heel Spurs

An order form for Heel Spurs.

This order form contains:

Multiple medications available.

Painful Wounds

This order form contains:

Multiple medications available.

Infected Wounds

An order form for Infected Wounds.

This order form contains:

Multiple medications available.

Fungal Skin Infections

An order form for Fungal Skin Infections.

This order form contains:

Multiple medications available.

Raynaud's Phenomenon

An order form for Raynaud's Phenomenon.

This order form contains:

Multiple medications available.

Diabetic Toes

An order form for Diabetic Toes.

This order form contains:

Multiple medications available.

Sweaty Feet

An order form for Sweaty Feet.

This order form contains:

Multiple medications available.

Rough / Dry Feet

An order form for Rough / Dry Feet.

This order form contains:

Multiple medications available.

Corns / Calluses

An order form for Corns / Calluses.

This order form contains:

Multiple medications available.

Burning Foot Syndrome

An order form for Burning Foot Syndrome.

This order form contains:

Multiple medications available.

Dry Mouth

An order form for Xerostomia (dry mouth).

This order form contains:

Multiple medications available.

Vertigo

An order form for Vertigo.

This order form contains:

Multiple medications available.

Tonsillitis / Tonsillectomy

An order form for Tonsillitis / Tonsillectomy.

This order form contains:

Multiple medications available.

Sinusitis

An order form for Sinusitis.

This order form contains:

Multiple medications available.

Pharyngitis

An order form for Pharyngitis.

This order form contains:

Multiple medications available.

Oral Thrush

An order form for Oral Thrush.

This order form contains:

Multiple medications available.

Nose Bleeds

An order form for Nose Bleeds.

This order form contains:

Multiple medications available.

Nausea (Inner Ear Problems)

An order form for Nausea.

This order form contains:

Multiple medications available.

Nasal Polyps

An order form for Nasal Polyps.

This order form contains:

Multiple medications available.

Mucositis

An order form for Mucositis.

This order form contains:

Multiple medications available.

MRSA Infections

An order form for MRSA Infections.

This order form contains:

Multiple medications available.

Local Anesthetics (Otic)

An order form for Local Anesthetics (Otic).

This order form contains:

Multiple medications available.

Lichen Planus

An order form for Lichen Planus.

This order form contains:

Multiple medications available.

Laryngitis

An order form for Laryngitis.

This order form contains:

Multiple medications available.

Herpes Labialis

An order form for Herpes Labialis.

This order form contains:

Multiple medications available.

Eosinophilic Esophagitis

An order form for Eosinophilic Esophagitis

This order form contains:

Multiple medications available.

Ear Wax Removal

An order form from Ear Wax Removal.

This order form contains:

Multiple medications available.

Burning Mouth Syndrome

An order form for Burning Mouth Syndrome.

This order form contains:

Multiple medications available.

Biofilms

An order form for Biofilms.

This order form contains:

Multiple medications available.

Aphthous Ulcers

An order form for Aphthous Ulcers.

This order form contains:

Multiple medications available.

Angular Cheilitis/Cheilosis

An order form for Angular Cheilitis/Cheilosis.

This order form contains:

Multiple medications available.

Acne

An order form for Acne.

This order form contains:

Multiple medications available.

Rosacea

An order form for Rosacea.

This order form contains:

Azelaic Acid

Metronidazole

Ketotifen

Ivermectin

(CPP) Vaginismus/Painful Intercourse

An order form for Chronic Pelvic Pain (CPP) Vaginismus/Painful Intercourse.

This order form contains:

Amitriptyline

Baclofen

Gabapentin

Lidocaine

Hirsutism

An order form for Hirsutism.

This order form contains:

Azelaic Acid

Metformin

Progesterone

Spironolactone

Finasteride

PCOS with Hirsutism & Acne

An order form for PCOS with Hirsutism & Acne.

This order form contains:

Progesterone

Metformin

Hair Loss (Women)

An order form for Hair Loss (Women).

This order form contains:

Finasteride

Minoxidil

Tretinoin

Spironolactone

Libido/Sexual Dysfunction (Scream Cream)

An order form for Libido/Sexual Dysfunction (Scream Cream).

This order form contains:

Arginine

Theophylline

Sildenafil

Nitroglycerin

Vulvar Lichen Sclerosis

An order form for Vulvar Lichen Sclerosis.

This order form contains:

Clobetasol Propionate

Tacrolimus

Ketotifen

Naltrexone

Vaginal Itching

An order form for Vaginal Itching.

This order form contains:

Naltrexone

Ketotifen

Vaginal Procedure Anesthetic (Mona Lista Touch™)

An order form for Vaginal Procedure Anesthetic.

This order form contains:

Lidocaine

Tetracaine

Genital Herpes

An order form for Genital Herpes.

This order form contains:

Acyclovir

Hydrocortisone

Lidocaine

Candida Glabrata

An order form for Candida Glabrata.

This order form contains:

Amphotericin

Vaginal Infections (Bacterial/Yeast/Combo/Viral)

An order form for treatment of Vaginal Infections.

This order form contains:

Boric Acid

Nystatin

Metronidazole

Chlorhexidine Gluconate

Vaginal Atrophy / Dryness / Painful Intercourse

An order form for women with Low Estrogen levels.

This order form contains:

Estradiol

Estriol

Sodium Hyaluronate

Dehydroepiandrosterone

Bio-Idential HRT (Oral)

An order form for HRT Oral treatments.

This order form contains:

Progesterone

Bi-Est

Tri-Est

Estradiol

Estriol

Bio-Idential HRT (Vaginal)

An order form for HRT Vaginal treatments.

This order form contains:

Estradiol

Estriol

Progesterone

Dehydroepiandrosterone

Blank

A blank order form for you to fill in.

This order form contains:

Multiple medications available.

Erectile Dysfunction Orals

Tablets, troches, and Rapid Dissolve Tablets.

This order form contains:

Tadalafil

Tadalafil RDT

Sildenafil

Sildenafil RDT

Vardenafil

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