• Allergy Drop Order Form

  • PLEASE ALLOW UP TO 14 BUSINESS DAYS FOR MIXING

  • * The person that the drops are being ordered for, not the parent or guardian's name that's filling out the form for the patient.

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          Allergy Drops3 Month Supply
          $280.00
            
          Allergy Drops6 Month Supply (Pre-approval from your Provider is required for 6 month supply orders)
          $560.00
            
          ShippingBox must be checked to have product shipped
          $9.90
            

          Credit Card
          Billing Address
        • DO NOT CLICK THE SUBMIT BUTTON MORE THAN ONCE OR DUPLICATE CHARGES WILL OCCUR TO YOUR CREDIT CARD

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