Choose Your Order Here B12 1000mcg/mL + Semaglutide 1000mcg/mL SQ 2 ML - 0.5 ML/wk - 325 B12 1000mcg/mL + Semaglutide 1000mcg/mL SQ 3 ML - 0.75 ML/wk - 350 B12 1000mcg/mL + Semaglutide 1000mcg/mL SQ 4 ML - 1 ML/wk - 380 B12 500mcg/mL + Tirzepatide 7000mcg/mL SQ 2ML - 0.5 ML/wk - 350 B12 500mcg/mL + Tirzepatide 7000mcg/mL SQ 3ML - 0.75 ML/w - 380 B12 500mcg/mL + Tirzepatide 7000mcg/mL SQ 4ML - 1 ML/wk - 420
COD
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Expiration Year 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042
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Gender Female Male
1. I agree not to take any over-the-counter medicines without approval from my pharmacist.
I Agree I Disagree
2. I agree not to take this medication if I am pregnant, breast feeding, or trying to get pregnant.
3. Please list all current medical conditions including high blood pressure. Choose "None" if none.
None I will specify
4. Is there anything in your medical history that you consider to be relevant? If yes, please specify. Choose "None" if none.
5. Please list all over-the-counter and prescription medications that you are currently taking and the frequency for each. Choose "None" if none.
6. Please list all past or present allergies including allergies to any medications. Choose "None" if none.
7. Please list all past surgeries and provide details including the condition that was treated with each surgery. Choose "None" if never.
8. Have you been treated with opiates, nitrates or narcotics or are you considered an opiate dependent patient? If yes, please specify. Choose "None" if no.
9. Have you been treated for any kind of mental health, substance abuse or emotional problem? Choose "None" if never.
10. Have you ever experienced or been treated for a seizure? Choose "None" if never.
11. Do you have a history of liver or kidney disease? Choose "None" if no.
12. Do you drink alcohol? If yes, please specify. Choose "None" if no.
13. What is your Activity Level per Week?
14. Please explain the specific medical reason for ordering this medication. The physician must know the exact nature of your medical problem in order to prescribe this medication.
Disclaimer: By submitting this order I am confirming that the medical questionnaire contains my full and honest medical history, which I have answered truthfully and that I am an adult (at least 18 years of age). I am competent to use the services offered and I have reviewed the Terms of Service and agree to them fully.
I understand once my order has been submitted that the pharmacy will not accept any requests for cancellations or refunds. I have double checked the information and confirm that all of the information is correct, and I will pay with a money order upon delivery (no cash is accepted).