Specialty Items Order Form


Enter the desired quantity for each item then scroll to the bottom and click “Submit Order”

When you click the “Submit Order” field your clinician will be e-mailed with the order.  If you need to make changes or ask any further questions, please call your clinician.  These ’specialty items’ are not added to your cart with the rest of your order. This order goes directly to your Clinician. Contact your Clinician to make arrangements to pay for and receive these items.

Please Note:
There can be no blanks in the “Quantity Desired” field, so be sure there is a number in every field.
 

Product Name

Size

Price

Quantity Desired

CogniSure

30T  

$49.95

Log in to order
DigestEZ® Large

360 CAPS  

$65.00

Log in to order
DigestEZ® Regular

180 CAPS  

$35.00

Log in to order
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