Online Order and Add-On Form

Name*

First NameLast Name

Date of Birth*

Date

Email*

example@example.com

Phone Number*

Area CodePhone Number

Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

My Products*

Nutrition and Supplements $99.99

Medication Responsiveness $99.99

Fitness & Weight Management$99.99

Diet & Metabolism $99.99

Bone Health$99.99

Full Comprehensive P23 Optimum $399.00

This test kit will include all assays available in the P23 Optimum covering a comprehensive test results powered by P23! Get all the power on your DNA unlocked at the palm on your hand with results available on your mobile device and interactive, instead of just a PDF report.

+ Add On: COVID-19 PCR$109.00

Our proprietary saliva based RT-PCR COVID-19 Test

+ Add-on: P23 Optimum PGX: Medications $599.00

Get all the power on your DNA unlocked at the palm on your hand with results available on your mobile device and interactive, instead of just a PDF report.

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Subtotal $0.00Shipping $0.00Total $0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country