Product Request FormComplete the form below to start the process. Name * First Name Last Name Date of Birth * Email * Cell Phone Number * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Do you have any medication allergies? If so, please list them * I agree to receiving notifications via text. Payment is due prior to us ordering your products. We will text and coordinate payment either via card, venmo, or cash app. All you will have to do is pick up product from Mister Meds Pharmacy (141 Clyde Street Abilene, TX) between 9 AM-5:00 PM once they notify you that your prescription is ready. * Agree Which product would you like to order? * NAD+ Injectable 200mg ($85) NAD+ Injectable 600 mg ($225) M.I.C.C Injections 10 ml ($125) Glutathione 10 ml Injections ($125) BPC-157 Injectable 15 mg ($250) BPC-157 30 Troches ($225) Sermorelin/Ipamoreline/Theanine 30 Troche ($225) CJC/Ipamoreline Injectable 3 ml ($250) AOD/CJC/Ipamoreline 30 Troches ($225) AOD/NAD 30 Troches ($225) PT 141 30 Troches ($225) Sildenafil/Tadalafil/Apomorphine 30 Troches ($225) BPC-157/TB 500 30 count Troche ($225) Bundle & Save $25 off if purchasing two or more items Questions/Comments (optional) All Sales are Final Upon Payment * We do not accept refunds on wellness products or weight loss injections. These items are custom-compounded and cannot be returned or resold. Please ensure you are committed before placing your order. Agree Legal Stuff: Client Privacy Rights. Terms and Conditions: https://docs.google.com/document/d/1lXGSUu3HkHxTQ57BZ5U60n-HWUFEMQhUf4xCT4nJSD8/edit?usp=sharing * I have read and agree to the terms above THANK YOU FOR YOUR ORDER! You are all set!You will be notified by Big Country Mobile Med or the Pharmacy once meds are in Client Privacy Rights. Terms and Conditions