Customized Virtual Prescription Pads

Our complimentary, virtual prescription pad makes it easy for you to communicate directly with your patients.

Using the virtual prescription pad and our Patient Fulfillment Program, you can let your patients know which Restorative Formulations to purchase, how to order them, and how they should be taken.

If you have questions or need more information, call 800-420-5801.

Practice Name

Name & Title

Title

Address

City, State, Zip

Country

Phone

Practice Email

Your Patient

Name

E-Mail

RF-1010-U Adaptogen 75 caps
RF-1020-U Adrenal Px Balance-75 Caps
RF-1030-U Adrenal Px Balance - 4 oz
RF-1040-U Adrenal Px DHEA -75 caps
RF-1050-U Adrenal Px DHEA 25 - 75 caps
RF-1060-U Adrenal Px L-BP - 75 Caps
RF-1071-U Bacopa 90 Caps
RF-1076-U Biotin Synergy 90 Caps
RF-1080-U Cardiac Calm Px 60 Caps
RF-1100-U Cholesterol Care 120 caps
RF-1111-U CortiCalm - 60 caps
RF-1113-U DopaMind - 60 caps
RF-1116-U Enfla-Mend Px - 120 caps
RF-1117-U Enfla-Mend Px 60 Caps
RF-1130-U Glucose Balance Px 120 Caps
RF-1160-U Estro Px-75 Caps
RF-1166-U Kava Calm Px - 30 caps
RF-1170-U HTN Px Original - 60 Caps
RF-1175-U HTN 180 Px (Extra Strength) - 60 Caps
RF-1176-U Liver Support Px-75 caps
RF-1177-U Lytic Vascular Px - 60 caps
RF-1178-U Iodine Px-60 Caps
RF-1181-U Immune Px 90 Caps
RF-1185-U Metabolic Nutrition - 60 Caps
RF-1186-U MoodBoost - 60 caps
RF-1188-U Microbiome Synergy - 60 Caps
RF-1189-U Berberine GS - 60 Caps
RF-1191-U Mitochondria Nutrition PQQ - 60 Caps
RF-1192-U Neuro Px ES- 60 caps
RF-1193-U Laxative Px - 60 caps
RF-1194-U Neuro Protect Px-60 caps
RF-1198-U Ox-LDL Px - 60 Caps
RF-1201-U Osteo Px - 60 Caps
RF-1202-U PCO Px-75 caps
RF-1204-U Paracide Px 90 Caps
RF-1210-U Respiratory EZ 60 Caps
RF-1220-U Rosmarinic Acid Px-75 Caps
RF-1222-U Senolytic Px - 15 caps
RF-1223-U SeroBoost - 60 caps
RF-1225-U Sleep - 60 Liquid Caps
RF-1240-U StressCalm Px 75 Caps
RF-1251-U Telomere Protect - 60 caps
RF-1255-U T-Cell Balance Px-60 caps
RF-1260-U ThyroCalm Px 120 Caps
RF-1290-U ThyroCare 75 Caps
RF-1300-U Thyroid Px - 75 caps
RF-1350-U UroProtect Px 60 Caps
RF-1455-U Vitamin D3 Balance - 60 Caps

Practice Name

Your Name

123 Your Street

Your City, ST 99999

123-456-7890

To Order Call 800-420-5801 or
Visit www.restorative.com

To access the patient fulfillment program use your Doctor's Authorization Code (phone number) at the top of the page when ordering.

(Please note your health care provider earns proceeds on sales of all Restorative products)

The statements above have not been evaluated by the FDA.
These products are not intended to diagnose, treat, cure or prevent any disease.